Cancer of esophagus is one of the more prevalent neoplasms from the aerodigestive tract. Although capable to be cured by its early recognition, patients have poor prognosis due to advanced stages seen at time of diagnosis. Because invasion of adjacent structures are mainly to the lower airways in cases of cancer located in the upper 2/3 of esophagus, bronchoscopic evaluation of such patients is recommended.
Study design of historic cohort in a series of 87 patients with carcinoma of esophagus submitted to flexible bronchoscopy (FB) from January 2003 to April 2005. They were predominant male (83.9%), 67.5 y.o. mean age (SD ± 8.4). Related symptoms were cough (41.4%), weight loss (39.1%), anorexia (13.8%), dyspnea (11.5%), weakness (11.5%). Smoking (94.3%) and alcohol (63.2%) consumption were high. After careful description of the bronchoscopy findings, a statistical analysis was made by chi-square and Fischer exact tests (p<0.05).
Patients were examined by FB after nasal insertion (73.6%), intravenous sedation using propofol (90.8%) and fentanil (79.3%). The main findings were extrinsic compression (33.3%), secretion (14.9%), blunt carina (10.3%), vocal cord paralysis or larynx lesion (8.4%), mucosal infiltration (9.2%), endobronchial tumor (8.0%) and normal (31.0%). Diagnostic samples were taken with bronchial biopsy (13.8%), bronchoalveolar lavage (6.9%), transbronchial punction (4.6%) and bronchial brushing (3.4%). Complications registered persistent hypoxemia (2.3%), bleeding (2.3%) and bronchospasm (1.1%). Association was confirmed between respiratory symptoms and abnormal findings at FB (p<0.05).
FB demonstrates significant alterations closely related to neoplasm in the airways of patients with carcinoma of esophagus (69%), without major complications.
Bronchoscopic evaluation is an easy and safe method for staging patients with carcinoma of esophagus.
Rogerio Xavier, None.