An evidence-based consensus statement on the role and application of endosonography in clinical practice

Maluf‐Filho, Fauze; Cm, Dotti; Halwan, Bhawna; Af, Queiros; Kupski, Carlos; Dm, Chaves; Fs, Nakao; Kumar, Amanika

doi:10.1055/s-0029-1215192

Cited by 32 publications

(14 citation statements)

References 56 publications

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“…Optimal treatment of patients with gastric cancer depends on accurately staging the cancer, and is most commonly accomplished through computed tomography (CT). Recently, endoscopic ultrasound (EUS) has been endorsed for the preoperative staging of gastric cancer by several groups, such as the National Comprehensive Cancer Network, the Brazilian Society of Gastrointestinal Endoscopy, and the Scottish Intercollegiate Guidelines Network [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of the utility of EUS for preoperative staging for gastric cancer

et al. 2012

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Background Accurate preoperative staging is important in determining the appropriate treatment of gastric cancer. Recently, endoscopic ultrasound (EUS) has been introduced as a staging modality. However, reported test characteristics for EUS in gastric cancer vary. Our purpose in this study was to identify, synthesize, and evaluate findings from all articles on the performance of EUS in the preoperative staging of gastric cancer. Methods Electronic literature searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1 January 1998 to 1 December 2009. All search titles and abstracts were independently rated for relevance by a minimum of two reviewers. Metaanalysis for the performance of EUS was analyzed by calculating agreement (Kappa statistic), and pooled estimates of accuracy, sensitivity, and specificity for all EUS examinations, using histopathology as the reference standard. Subgroup analyses were also performed. Results Twenty-two articles met our inclusion criteria and were included in the review. EUS pooled accuracy for T staging was 75% with a moderate Kappa (0.52). EUS was most accurate for T3 disease, followed by T4, T1, and T2. EUS pooled accuracy for N staging was 64%, sensitivity was 74%, and specificity was 80%. There was significant heterogeneity between the included studies. Subgroup analyses found that annual EUS volume was not associated with EUS T and N staging accuracy (P = 0.836, 0.99, respectively). Conclusion EUS is a moderately accurate technique that seems to describe advanced T stage (T3 and T4) better than N or less advanced T stage. Stratifying by EUS annual volume did not affect EUS performance in staging gastric cancer.

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Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis of the utility of EUS for preoperative staging for gastric cancer

et al. 2012

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“…14 It has been shown to impact treatment strategies in a significant proportion of patients with esophageal cancer. 15 An international multicenter study that compared EUS staging of esophageal cancer to CT alone showed that the additional information obtained by EUS changed patient management in one-third of cases with the majority (85%) of these changes being the advocation of nonsurgical and palliative measures due to identification of advanced disease.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasonography in esophageal cancer leads to improved survival rates: Results from a population‐based study

Wani

Das

Rastogi

et al. 2014

Cancer

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Background and Aims The advantages of endoscopic ultrasound (EUS) and computed tomography-positron emission tomography (CT-PET) in relation to survival in esophageal cancer (EC) patients are unclear. This study aimed to assess the effect of EUS, CT-PET and its combination on overall survival relative to cases not receiving these procedures. Methods Patients aged ≥ 66 years diagnosed with EC were identified in the Surveillance, Epidemiology, and End Results-Medicare linked database. Cases were split into four analytic groups: EUS only (n=318), CT-PET only (853), EUS+CT-PET (189) and “no EUS or CT-PET” (2,439). Survival times were estimated by Kaplan-Meier method and compared by using log-rank test for each group versus the “no EUS or CT-PET” group. Multivariable Cox proportional hazards models were used to compare 1, 3 and 5-year survival rates. Results Kaplan-Meier analyses showed that patients undergoing EUS, CT-PET and EUS+CT-PET had improved survival for all stages, all compared with “no EUS or CT-PET”, with the exception of stage 0 disease. Receipt of EUS increased the likelihood of receiving endoscopic therapies, esophagectomy and chemoradiation. Multivariable Cox proportional hazards models showed that receipt of EUS was a significant predictor for improved 1-year (HR 0.49, 95% CI 0.39–0.59, p<0.0001), 3-year (HR 0.57, 95% CI 0.48–0.66, p<0.0001) and 5-year (HR 0.59, 95% CI 0.50–0.68) survival. Similar results were noted when results were stratified based on histology, as well as for CT-PET and EUS+CT-PET groups. Conclusions Receipt of either EUS or CT-PET alone in EC patients is associated with improved 1, 3 and 5-year survival. Future studies should identify barriers to dissemination of these staging modalities.

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“…Incorporation of EBM principles into EUS practice is indicated for an objective evaluation of the technique; it could also reveal certain aspects that warrant further research [60,61]. The present review aimed to appraise EUS literature of the period 2001-2010 in a comprehensive, comparative manner, grading studies according to levels of evidence and highlighting the most thoroughly investigated topics.…”

Section: Discussionmentioning

confidence: 99%

Levels of Evidence in Endoscopic Ultrasonography: A Systematic Review

et al. 2011

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An evidence-based consensus statement on the role and application of endosonography in clinical practice

Cited by 32 publications

References 56 publications

A systematic review and meta-analysis of the utility of EUS for preoperative staging for gastric cancer

A systematic review and meta-analysis of the utility of EUS for preoperative staging for gastric cancer

Endoscopic ultrasonography in esophageal cancer leads to improved survival rates: Results from a population‐based study

Levels of Evidence in Endoscopic Ultrasonography: A Systematic Review

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