Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2017; 23(5): 751-762
Published online Feb 7, 2017. doi: 10.3748/wjg.v23.i5.751
Is endoscopic ultrasound examination necessary in the management of esophageal cancer?
Tomas DaVee, Jaffer A Ajani, Jeffrey H Lee
Tomas DaVee, Jeffrey H Lee, Department of Gastroenterology, Hepatology and Nutrition, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
Jaffer A Ajani, Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
Author contributions: DaVee T, Lee JH contributed to conception and design; DaVee T contributed to literature review and data acquisition; DaVee T, Ajani JA and Lee JH contributed to analysis and interpretation, DaVee T drafted the article; DaVee T and Lee JH contributed to critical revision and editing; DaVee T, Ajani JA and Lee JH contributed to final approved of the article.
Conflict-of-interest statement: No potential competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jeffrey H Lee, MD, MPH, FASGE, FACG, AGAF, Department of Gastroenterology, Hepatology and Nutrition, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit Number 1466, Houston, TX 77030, United States. jefflee@mdanderson.org
Telephone: +1-713-7945073 Fax: +1-713-5634408
Received: September 20, 2016
Peer-review started: September 20, 2016
First decision: October 10, 2016
Revised: November 23, 2016
Accepted: December 21, 2016
Article in press: December 21, 2016
Published online: February 7, 2017
Core Tip

Core tip: Endoscopic ultrasound (EUS) is not necessary or adds little in management of many cases, such as, in patients with distant metastases or following pre-operative (neoadjuvant) chemoradiotherapy. EUS is the most sensitive test to exclude local tumor invasion and regional nodal disease that would make endoscopic resection (ER) unsafe or unnecessary. Thus, for early esophageal cancer staging, EUS followed by ER and histopathologic analysis, remains the standard-of-care. For a minority of locally advanced cancers, EUS-fine-needle aspiration can define the radiotherapy field by providing tissue samples of suspicious lymph nodes that are remote from the primary tumor.