The assessing the left bronchial invasion of esophageal cancer in computed tomography

Background and aims: The prognosis of esophageal squamous cell carcinoma varies according to the degree of invasion of the tumor in the organ wall. When the trachea and the main bronchus are involved in esophageal carcinoma, the disease is classified as incurable and the mortality is lower than that for patients who can be treated with curative surgery. To evaluate the carcinoma invading the trachea and main bronchus, retrospectively, we investigated computed tomography (CT) findings. Methods: Of 74 patients with or without proven tracheobronchial involvement who underwent thoracotomy for esophagectomy and Surgery disclosed tumor invasion in pericardium, aorta, pleura, trachea, left main bronchus and parenchyma. Ten patients were not operated upon but exhibited invasion to respiratory tract by broncho-fiber scope. Results: Lt. main bronchus (NMS angle) were statistically significant in patients with and without invasion. (P<0.05) Conclusion: It is our conclusion that preoperative evaluation by CT plays an important role whether the tumor is resectable or not. Correspondence to: Hiroshi Makino, MD, Department of Surgery, Nippon Medical School, Tama Nagayama Hospital, Tokyo, Japan. 1-7-1, Nagayama, Tama-city, Tokyo, Japan; Tel: +81-42-371-2111; Fax: +81-42-372-7384; E-mail: [email protected]