Try it
General Surgery · Oesophagus: staging of carcinoma
Sample itemA patient with biopsy-proven oesophageal carcinoma and no distant disease on CT needs assessment of depth of invasion and regional nodes. Which investigation is the most accurate for this purpose?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Endoscopic ultrasound
Endoscopic ultrasound is the best investigation for T and N staging, showing the layers of the wall and peri-oesophageal nodes, and allows fine needle aspiration. CT assesses distant metastases and PET-CT improves detection of occult disease. Barium swallow only shows the length and stricture.
Option by option
A. Barium swallow
Barium swallow does not assess invasion depth.
B. Endoscopic ultrasound (correct)
Correct. EUS best delineates wall invasion and local nodes.
C. Plain chest film
A chest film has no value for staging.
D. Serum CEA
CEA is not a reliable staging tool.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
More General Surgery questions
- HerniaA groin hernia that passes medial to the inferior epigastric vessels through Hesselbach'…
- BurnsA 70 kg adult has burns over 40% of the body surface. By the Parkland formula, what tota…
- HerniaA hernia that enters the inguinal canal through the deep ring, lateral to the inferior e…
- Intestinal obstructionWhat is the commonest cause of small bowel obstruction in adults?