Résumé
Les performances diagnostiques de l’échoendoscopie œsophagienne ne sont plus à démontrer dans le bilan du cancer de l’œsophage. De nombreuses études ont montré que la corrélation entre l’échoendoscopie et l’analyse des pièces opératoires pouvait atteindre 85 % pour l’extension dans la paroi œsophagienne et 75 % pour l’atteinte ganglionnaire [1–4], mais il existe une certaine variabilité interobservateurs en fonction du siège des adénopathies qui peut en limiter la portée [5, 6].
L’un des avantages de l’échoendoscopie est de fournir une étude relativement exhaustive des aires ganglionnaires médiastinales et cœliaques et de l’extension locale qui permet d’établir une classification en stades de manière similaire à la classification pTNM dont on connaît actuellement la portée pronostique [2, 7].
Avec l’évolution actuelle des techniques chirurgicales et non chirurgicales, on peut se poser la question de l’intérêt de FEES, sur sa capacité à prédire le pronostic de ces cancers avec de telles limitations.
Cet article vise à répondre à cette question et à définir quelles solutions proposer pour affiner la prédiction de l’EES dans le but d’apprécier le pronostic de ces cancers, à la lumière des derniers travaux publiés.
Summary
The diagnostic accuracy of endoscopic ultrasonography (EUS) is currently well known for the staging of esophageal cancer. Numerous studies have shown that the agreement between EUS and histopathology of the resected specimen could reach 85 %for the transmural extent, and 75 % for the nodal extent [1–4].However a certain interobserver variability exists as a function of the lymph nodes site, that can limit the usefulness of the examination [5, 6].
One of the most interesting advantages of EUS is that it gives a relatively exhaustive assessment of the mediastinal and celiac lymphatic sites and of the local extent which permits to establish a classification in a similar manner to the pTNM classification of which the predictive prognostic value is currently well known [2, 7].
With the continuing improvement of surgical and non-surgical techniques, the question can be raised whether EUS is able to predict the prognosis of cancers with such limitations.
The aim of this article is to try to answer some questions and to search for some solutions in order to improve the predictive prognostic value of EUS.
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Burtin, P. Pronostic des cancers de l’œsophage — échoendoscopie. Acta Endosc 34, 27–30 (2004). https://doi.org/10.1007/BF03008971
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DOI: https://doi.org/10.1007/BF03008971