Details

Autor(en) / Beteiligte

• Kim, Jung
• Kim, Sang Gyun
• Chung, Hyunsoo
• Lim, Joo Hyun
• Choi, Ji Min
• Park, Jae Yong
• Yang, Hyo-Joon
• Han, Seung Jun
• Oh, Sooyeon
• Kim, Min Seong
• Kim, Hyun Ju
• Hong, Hyoungju
• Lee, Hee Jong
• Kim, Jue Lie
• Lee, Eunwoo
• Jung, Hyun Chae

Titel

Clinical efficacy of endoscopic ultrasonography for decision of treatment strategy of gastric cancer

Ist Teil von

• Surgical endoscopy, 2018-09, Vol.32 (9), p.3789-3797

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2018

Quelle

SpringerNature Journals

Beschreibungen/Notizen

• Background Accurate preoperative tumor staging of gastric cancer is indispensable with expansion of indications for laparoscopic surgery and endoscopic resection. It is important to distinguish mucosal cancer (T1a) in smaller lesion and differentiate early gastric cancer (EGC) in larger lesion considering endoscopic resection indication and laparoscopic surgery indication. We evaluated the clinical outcomes of endoscopic ultrasonography (EUS) for the decision of treatment strategy of gastric cancer compared with pathological staging. Methods The patients who underwent EUS and surgical or endoscopic resection for gastric cancer were retrospectively reviewed between September 2005 and February 2016. The depth of tumor invasion (T staging) by EUS was compared with the pathological staging after endoscopic or surgical resection. Results A total of 6084 patients were finally analyzed. The accuracy rates for T1a and EGC were 75.0 and 89.4%, respectively. The overall accuracy of T staging by EUS was 66.3% when divided by T1a, T1b, and over T2. The accuracy of EUS prior to endoscopic resection was 75.1% in absolute indication and 73.1% in expanded criteria, respectively. The accuracy rates for T1a with lesion ≤ 2 cm in miniprobe EUS and EGC with lesion > 2 cm in conventional EUS were 84.6 and 83.2%, respectively. In multivariate analysis, presence of ulcer, large tumor size, and radial EUS were associated with overestimation, and small tumor size and miniprobe were associated with underestimation in T staging. Conclusions EUS showed the high accuracy of 84.6% for T1a in lesion ≤ 2 cm in miniprobe EUS and 83.2% for EGC in lesion > 2 cm in conventional EUS, respectively. EUS can be a complementary diagnostic method to determine endoscopic or surgical treatment modality.