Upper GI 2016

EUS - Reassessment after neoadjuvant chemotherapy (NAC)

Challenges for EUS post neoadjuvant therapy • Unable to differentiate fibrosis / inflammation from tumour (resulting in over-staging) • Unable to detect microscopic of viable tumour (resulting in under-staging) • T staging accuracy 29%

Overstaged 23/45 (51%)

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Understaged 7/45 (16%)

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• N staging accuracy 62% • Conclusion: EUS is an unreliable tool for staging esophageal cancer after NAC*

*Heinzow, H. S., H. Seifert, et al. (2013). J Gastrointest Surg 17 (6): 1050-1057.