Can the length of an esophageal cancer during endoscopy predict its T-stage by endoscopic ultrasound?

Purpose: To study the correlation of endoscopically measured length of an esophageal cancer with T-stage by endoscopic ultrasound (EUS). Twenty patients with esophageal carcinoma underwent endoscopic measurement of the length of the tumor. Six patients had luminal stenosis, thus the entire length of the tumor could not be assessed and were excluded. The other 14 patients following upper endoscopy underwent T-staging by radial EUS at 7.5 & 12 MHz. Results: EUS T-stage was T₁ (invading the mucosa or submucosa) in 4 patients, T₂ (invading the muscularis) in 5 patients, and T₃ (penetrating through the muscularis) in 5 patients. The lengths of esophageal cancer in these patients, was as follows: T-Stage Length of Tumor Mean Length T₁ (n=4) 1cm, 1cm, 4cm, 5cm 2.7cm T₂ (n=5) 2cm, 3cm, 3cm, 4cm, 7cm 3.8cm T₃ (n=5) 3cm 5cm, 8cm, 9cm, 9cm 6.8cm T₁ or T₂ lesions ≤ 5cm = 8/9 (89%) T₃ lesions ≥ 5cm = 4/5 (80%) Conclusions: 1. Esophageal cancers that are ≤ 5cm have a greater chance of being T₁ or T₂ by EUS. 2. An esophageal carcinoma that is ≥ 5cm in length is more likely to be T₃ by EUS. 3. Increasing endoscopic length of an esophageal cancer correlates with increasing T-stage by EUS.