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What is the current role of endoscopic ultrasonography in oesophageal cancer?

Endoscopic ultrasonography is, probably, the most significant progress in gastrointestinal endoscopy of the last few years, and it is on the way to becoming the gold standard for pre-treatment staging of oesophageal carcinoma. Once computed tomography scan has ruled out distant metastases or evident local invasion, endoscopic ultrasonography plays a key role in an adjunctive evaluation and planning of treatment. The diagnostic accuracy of endoscopic ultrasonography in oesophageal cancer is excellent. Its main limitations are: poor differentiation between early mucosal and submucosal cancer, insufficient accuracy in detecting early lymph node invasion, and lack of complete tumour evaluation in cases of high-grade strictures. The role of endoscopic ultrasonography in post-treatment assessment is still limited by some artifacts. However, all these limitations will soon be overcome by some technical improvements.