The results from the author’s ph.d. demonstrated the value of EUS as a single imaging modality in the pretherapeutic assessment of patients with esophageal, gastric and pancreatic cancer. But it was also evident that this technology alone was unable to perform a complete evaluation of these patients. With the results from the present work the author has defined and tested a new evaluation strategy based on the combination of EUS and Laparoscopic Ultrasonography (LUS). This combination was supplemented by EUS and LUS guided biopsies in those situations, where a malignant biopsy would change the subsequent treatment strategy. The combination of EUS and LUS was lenient, safe and cost-effective and at the same time provided additional, important pretherapeutic information regarding possible treatment options and the prognosis. It may be speculated if the improved patient selection has had a positive impact on the prognosis of the R0 resected patients. The combined strategy may also allow a more homogenous selection of patients for future treatment trials.