Staging Investigations in Patients with Esophageal Cancer: A Critical Re-Appraisal

textabstractThe incidence of esophageal cancer has been increased over the years. In 1989, the incidence was 6.9 cases of esophageal cancer per 100,000 men and 2.4 cases per 100,000 women in The Netherlands. In 2003, the incidence had increased to 11.9 cases per 100,000 men and 3.8 cases per 100,000 women. Currently, about 1,400 patients are annually diagnosed with esophageal cancer in The Netherlands (1). The two major types of esophageal cancer are squamous cell carcinoma and adenocarcinoma, which comprises more than 90% of esophageal cancer cases. Complaints, such as weight loss, dysphagia or pain, usually arise in an advanced stage of the disease. As a consequence, more than 50% of patients have already locally advanced cancer, lymph node metastases, or distant metastases at the time of presentation (2). The 5-year survival rate for esophageal cancer is low, i.e., 10-15% (3)