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Diagnostic and Therapeutic Endoscopy
Volume 2011 (2011), Article ID 356538, 6 pages
http://dx.doi.org/10.1155/2011/356538
Clinical Study

Dilation of Malignant Strictures in Endoscopic Ultrasound Staging of Esophageal Cancer and Metastatic Spread of Disease

Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, 4241 MFCB, 1685 Highland Avenue, Madison, WI 53705, USA

Received 21 July 2011; Revised 30 September 2011; Accepted 4 October 2011

Academic Editor: Tony C. K. Tham

Copyright © 2011 Shawn M. Hancock et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Dilation of malignant strictures in endoscopic ultrasound (EUS) staging of esophageal cancer is safe, but no data exists regarding the subsequent development of metastases. Aim. Compare the rates of metastases in esophageal cancer patients undergoing EUS staging who require esophageal dilation in order to pass the echoendoscope versus those who do not. Methods. We reviewed consecutive patients referred for EUS staging of esophageal cancer. We evaluated whether dilation was necessary in order to pass the echoendoscope, and for the subsequent development of metastases after EUS at various time intervals. Results. Among all patients with similar stage (locally advanced disease, defined as T3, N0, M0 or T1-3, N1, M0), there was no difference between the dilated and nondilated groups in the rates of metastases at 3 months (14% versus 10%), 𝑃 = 1 . 0 , 6 months (28% versus 20%), 𝑃 = 0 . 6 9 , 12 months (43% versus 40%), 𝑃 = 1 . 0 , or ever during a mean followup of 15 months (71% versus 55%), 𝑃 = 0 . 4 8 . Conclusions. Dilation of malignant strictures for EUS staging of esophageal cancer does not appear to lead to higher rates of distant metastases.