RT Journal Article
SR Electronic
T1 Bronchoscopic assessment of airway invasion by esophageal cancer: A retrospective study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p607
VO 38
IS Suppl 55
A1 Rolo, Rui
A1 Pacheco, Cecilia
A1 Alves, Daniela
A1 Cruz, Joao
A1 Ferreira, Lurdes
A1 Cunha, Joao
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p607.abstract
AB Background: Fiberoptic bronchoscopy (FOB) is frequently used to evaluate possible invasion of the tracheobronchial tree by esophageal cancer.Objective: To evaluate the diagnostic utility of FOB for the assessment of airway involvement by esophageal carcinoma and its resectability.Material and Methods: Retrospective study of bronchoscopies in patients with potentially operable esophageal carcinoma, correlating its findings with other staging modalities, in the last 6 years.Results: We included 40 patients, 87.5% male, mean age 63±13.2 years. Respiratory symptoms appeared in 15% of cases, all of them with endoscopic abnormalities.In 16 (40%) patients, FOB revealed: extrinsic compression in 12 (30%) and infiltration of the bronchial mucosa in 4 (10%) cases. These features were more frequent at the left main bronchus (n=5) and middle third of the trachea (n=4).Comparing CT with FOB, we found that observed or suspected invasion of the trachea on CT (21 patients), was only confirmed by FOB in 4 cases (19%). In 3 patients with endoscopic abnormalities, CT revealed no invasion of the bronchial tree.In cases of suspected airway involvement (n=8) by endoscopic ultrasound (EUS), 3 had wall protusion without evidence of mucosa's infiltration.The overall accuracy of FOB with multiple brush cytology and bronchial biopsy in confirming or excluding airway invasion was 95%. Normal endoscopic appearance had a negative predictive value of 100%.In 3 patients FOB was the decisive staging procedure, excluding surgical treatment.Conclusion: Bronchoscopy with biopsy and brush cytology is a very accurate procedure in assessing potential airway invasion by esophageal cancer. CT and EUS findings alone are not reliable.