Endoscopic ultrasonography in preoperative staging of gastric cancer: determination of tumor invasion depth, nodal involvement and surgical resectability

Xi, Weidong; Zhao, Cong; Ren, Guosheng

doi:10.3748/wjg.v9.i2.254

Cited by 66 publications

(46 citation statements)

References 23 publications

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“…Factors which have been described in cases of overstaging in other series include: inflammation, peritumorous necrosis and fibrosis -which usually exists in ulcerated tumor lesions-or obtaining ultrasound images tangential to the gastric wall, above all in tumors located in gastric antrum, incisura and fundus. Errors due to understaging may be due to deep microscopic invasion undetectable by the technique, ultrasound artefacts in relation to air content, mucous or food remains retained in the stomach or anatomical characteristics such as the absence of serosa at the lesser curvature and anterior wall which is why tumors in this location may be incorrectly interpreted as T2 despite transwall infiltration (8)(9)(10)(11)(12). Diagnostic precision in gastric cancer endoscopic ultrasound ganglion staging is lower than in T staging and varies from 55 to 87% in published series (3).…”

Section: Discussionmentioning

confidence: 99%

“…Thus the diagnostic precision for stage T varies between 70 and 90% depending on the series and on what type of endoscopic ultrasound is used, ultrasound frequencies and the location of the tumor (cardia or rest of the stomach) (8)(9)(10)(11)(12) deep staging are observed in stage T2 (8-12) tumors diagnosed by endoscopic ultrasound. On most occasions, in our series, it was caused by overstaging (tumors in stage T1 that were wrongly interpreted as being in stage T2).…”

Section: Discussionmentioning

confidence: 99%

“…However, the importance that these have for everyday medical practice has been cause for debate. While some authors do not consider a preoperational endoscopic ultrasonography study essential, as the management of these patients is surgical, independently of the loco-regional stage (7), other authors consider that the additional information supplied by endoscopic ultrasonography with regards to other imaging techniques may have important implications in the therapeutic management of these patients (8,9).…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of endoscopic ultrasonography in preoperative gastric cancer staging: diagnostic yield and therapeutic impact

Repiso

Gómez-Rodríguez

López-Pardo

et al. 2010

Rev. esp. enferm. dig.

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Objectives: to evaluate the diagnostic yield of endoscopic ultrasonography in loco-regional staging of gastric cancer in our medium and to determine the impact of this technique on later therapeutic management.Material and methods: this is a retrospective study carried out on patients histologically diagnosed with gastric adenocarcinoma who had been referred for endoscopic ultrasonographic examination. The technique results were compared with those obtained from surgical samples and/or from exploratory laparoscopylaparotomy. We compared the initial therapeutic decision based on conventional diagnostic techniques with the final therapeutic management based on the endoscopic ultrasonography results.Results: forty-six patients with gastric adenocarcinoma were included in the study (a reference exploration was available in 36 cases). Diagnostic precision was 70% in stage T, while in stages T1, T2, T3 y T4 was 100, 38, 82, and 100%, respectively. The sensitivity and specificity to differentiate T1-2 from T3-4 was 94 and 85%, respectively. We could not identify factors associated with obtaining a correct diagnosis in staging T. Diagnostic precision was 72% for stage N (N0: 58%; Nx 88%). The presence of free perigastric fluid was identified in 7 cases; the presence of peritoneal carcinomatosis was later confirmed in 5 of these. The result of endoscopic ultrasonography led to a modification in the subsequent therapeutic management in 13 patients (28%).Conclusions: endoscopic ultrasonography is a useful technique for loco-regional staging of gastric adenocarcinoma, which may have important implications in the therapeutic management of these patients.Key words: Gastric cancer. Endoscopic ultrasonography. Treatment. RESUMENObjetivos: valorar la rentabilidad diagnóstica de la ecoendoscopia en la estadificación locorregional del cáncer gástrico en nuestro medio y determinar el impacto de la técnica sobre el manejo terapéutico posterior.Material y métodos: estudio retrospectivo realizado en pacientes diagnosticados histológicamente de adenocarcinoma gástri-co que habían sido remitidos para la realización de ecoendoscopia. Se comparó el resultado de la técnica con el estudio final obtenido en la pieza operatoria y/o laparoscopia-laparotomía exploradora. Se comparó la decisión terapéutica inicial basada en los resultados de las técnicas diagnósticas convencionales, con el manejo terapéu-tico final basado en el resultado de la ecoendoscopia.Resultados: se incluyeron en el estudio 46 pacientes con adenocarcinoma gástrico (en 36 de los cuales se disponía de exploración de referencia). La precisión diagnóstica fue del 70% para el estadIo T, y para T1, T2, T3 y T4 del 100, 38, 82 y 100%, respectivamente. La sensibilidad y especificidad para diferenciar el estadio T1-2 del T3-4 fue del 94 y 85% respectivamente. No se identificaron factores relacionados con la obtención de un diagnóstico correcto en la estadificación T. La precisión diagnóstica fue del 72% para el estadio N (N0: 58%; Nx 88%). En 7 pacientes se identificó la pr...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Usefulness of endoscopic ultrasonography in preoperative gastric cancer staging: diagnostic yield and therapeutic impact

Repiso

Gómez-Rodríguez

López-Pardo

et al. 2010

Rev. esp. enferm. dig.

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“…staging tumors by determining the T value has been much improved with EUS having an accuracy of between 78 -92 [5][6][7][8][9][10][11] , and CT between 69 -89 9, 12-18 .…”

mentioning

confidence: 99%

“…However, the accuracy of establishing the N category is still poor ; 63 -78 using EUS [5][6][7][8][9][10][11] and 51 -78 using CT 9,[12][13][14][15][16][17][18] . The N category estimates 5-year survival rate in patients with N0 gastric cancer as 89.4 , but 68.3 in those with N1 disease 19 .…”

mentioning

confidence: 99%

Expression of Standard CD44 in Advanced Gastric Cancer: Relationship with Metastasis to Lymph Nodes

Arima

Kunimura

Date

et al. 2010

Showa Univ J Med Sci

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IntroductionGastric cancer is the second most common cause of cancer related mortality worldwide 1 . Complete surgical resection, the only potentially curative treatment for advanced gastric cancer, can only be performed on a small subgroup of patients. In 30 to 50 of patients undergoing surgical exploration, the intent of the surgery is to cure the patient. However, almost 60 of patients who undergo an R0 curative resection relapse and die of their disease 2, 3 .Clinical staging is determined using TNM classi cation : T indicating depth of invasion of the primary tumor, N nodal metastasis, and M distant metastasis. This classi cation system is useful to estimate patient prognosis. Currently, endoscopic ultrasound EUS and computed tomography CT are widely used for preoperative tumor staging 4 . The accuracy of 58 / 98 of tumors. CD44s expression showed no signi cant relationship with patient age or gender, or tumor location, size or macroscopic / microscopic classi cation. However, CD44s expression showed a signi cantly negative relationship with metastasis to lymph nodes p 0.0001 . Thus, in T2-T3 gastric cancer, loss of CD44s expression suggests that metastasis of the tumor to lymph nodes is likely.

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Diagnostic accuracy of endoscopic ultrasonography (EUS) for the preoperative locoregional staging of primary gastric cancer

Mocellin

Pasquali

2015

Cochrane Database of Systematic Reviews

161

118

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Endoscopic ultrasonography in preoperative staging of gastric cancer: determination of tumor invasion depth, nodal involvement and surgical resectability

Cited by 66 publications

References 23 publications

Usefulness of endoscopic ultrasonography in preoperative gastric cancer staging: diagnostic yield and therapeutic impact

Usefulness of endoscopic ultrasonography in preoperative gastric cancer staging: diagnostic yield and therapeutic impact

Expression of Standard CD44 in Advanced Gastric Cancer: Relationship with Metastasis to Lymph Nodes

Diagnostic accuracy of endoscopic ultrasonography (EUS) for the preoperative locoregional staging of primary gastric cancer

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