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European Journal of Cardio-Thoracic Surgery, Vol 3, 33-36, Copyright © 1989 by European Association for Cardio-thoracic Surgery

ARTICLES

The role of computed tomography in assessing the operability of oesophageal carcinoma

CG Markland, A Manhire, P Davies, D Beggs, WE Morgan and FD Salama
Department of Thoracic Surgery, City Hospital Nottingham, UK.

The reliability of CT scanning in assessing resectability in carcinoma of the oesophagus was investigated prospectively by direct comparison with the operative findings. Over 11 months, 38 patients judged potentially operable following conventional investigation underwent CT scanning from the thoracic inlet to the level of the adrenal glands. These patients were then explored surgically with a view to resection. The CT findings were assessed by two radiologists without access to clinical information. Operative findings were recorded by the surgeon. Comparison was made between the tomographic and surgical findings specifically assessing: longitudinal tumour extent, direct mediastinal infiltration, invasion of other mediastinal structures, lymph node involvement and the presence of hepatic and pulmonary metastases. The sensitivity and specificity of the scan for each feature was then calculated. Scan sensitivity was poor, ranging from 0%-66.7%. Specificity was better with a range of 70.8%-100% according to the criterion studied. We conclude that the poor sensitivity means that CT scanning is of little value in the preoperative assessment of resectability in oesophageal carcinoma.

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