EAES Academy

Oesophageal cancer is the 14th most common cancer in the United Kingdom. It accounts for about 5% of cancer related deaths in this country. The prognosis of oesophageal cancer is directly related to the stage of the disease when it is diagnosed, with better survival chances in patients who have it diagnosed it at an earlier stage. Computed tomography (CT) and Endoscopic ultrasound (EUS) are two important staging investigations for oesophageal cancer. The role of EUS in oesophageal cancers is to determine the locoregional staging and assessment of the local lymph node status. It also helps to direct therapy for early oesophageal cancers including submucosal dissection or mucosal resection. CT is routinely performed in all patients with oesophageal cancer for diagnosis and staging. It helps to pick up T2, T3 and T4 stage disease better than T1. Thus, performing EUS selectively in patients will help to avoid an additional investigation for the patient which may delay the institution of definitive treatment to oesophageal cancer patients. Bearing this in mind, we conducted an audit of all the patients who have had oesophageal cancer resections in our trust over the last 5 years. EUS was found to be more useful in patients who had tumour stage undefined on CT scan as opposed to T1 and above. This has directed a change in our cancer pathways to direct patients with higher stages to earlier treatment and avoided EUS in these patients.