VALUE OF COMPUTED-TOMOGRAPHY IN PREOPERATIVE EVALUATION OF RESECTABILITY AND STAGING IN ESOPHAGEAL-CARCINOMA

Objective-To evaluate computed tomography (CT) as a method of staging patients with oesophageal carcinoma. Design-Retrospective study. Setting-Ullevaal Hospital, Oslo, Norway. Subjects-85 patients who presented with oesophageal carcinoma between February 1982 and December 1989. Interventions-Assessment by CT was made in all patients. Main outcome measures-Correlation with findings at operation, and histological examination of operative specimens. Results-From the findings at operation in the 46 patients who were operated on (resection, n = 39; exploration only, n = 7) the sensitivity, specificity, and accuracy of CT staging of the growth were 80 %, 91 %, and 88 %, and when histological confirmation of infiltration was taken into consideration the figures were 25 %, 84 %, and 54 %, respectively. The sensitivity, specificity, and accuracy of CT detection of lymph node metastases were 22 %, 95 %, and 55 %. Conclusion-Staging of oesophageal cancer with CT before operation is useful in judging resectability, but the smaller tumours should be assessed with caution. CT is unreliable in the diagnosis of the depth of infiltration and the presence of lymph node metastases compared with histological examination.