Endoscopic Ultrasonography (EUS) in Preoperative Staging of Gastric Cancer - Demand and Reality

• Authors: Lutz Meyer , Frank Meyer , Uwe Schmidt , Ingo Gastinger , Hans Lippert , Oraz Wschodnioniemiecka Grupa Na Rzecz Kontroli Jakości i Rozwoju Regionalnego w Chirurgii
• Languages of publication: EN

Abstracts

EN

Exact pretherapeutic staging is considered to be essential for decision-making in the therapeutic algorithm of gastric cancer.The aim of the study was to characterize the role and value of EUS in the diagnostic and therapeutic management of gastric cancer in daily surgical practice.Material and methods. Thousand one hundred thirty nine patients with primary gastric cancer from 80 hospitals of each profile of care were enrolled in this systematic clinical prospective multicenter observational study over a time period of 12 months. The characteristics of the diagnostic management, in particular, of EUS were documented. The preoperative EUS findings were compared with the T stage (T1 to T4) and the N category (N+ or N-) revealed by the histopathologic investigation of the surgical specimen. By the mean of X2 test, the impact of EUS on the therapeutic decision-making was determined.Results. Pretherapeutic EUS was only performed in 27.4% (n=312) of all patients. Overall, the diagnostic accuracy for the T stage was 42.6% in average. The subgroup analysis showed the following results: T1, 31.5%; T2, 42.6%; T3, 65.2%; T4, 17.6%. The correct predictive value of the N category was 71.3% reaching a sensitivity of 69.7% and a specificity of 73.3%. Overstaging was observed in 45.8%, understaging in only 10.8%. Additional diagnostic information by EUS was only provided in 4.7% of subjects.Conclusions. The present study indicates the variability, limited reliability and only moderate acceptance of EUS in diagnosing gastric cancer in daily practice. In particular, the prediction of the T stage does not reach the data reported in the literature, which were mostly achieved in specific EUS studies.

Keywords

EN

endoscopic ultrasonography (EUS); gastric cancer; quality control; multicenter observational study

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 3
• Pages: 152-157

Dates

published

1 - 2 - 2012

online

28 - 5 - 2012

Contributors

author

Lutz Meyer

author

Frank Meyer

author

Uwe Schmidt

• StatConsult, Magdeburg

author

Ingo Gastinger

• Institute for Quality Control, University Hospital, Magdeburg

author

Hans Lippert

author

Oraz Wschodnioniemiecka Grupa Na Rzecz Kontroli Jakości i Rozwoju Regionalnego w Chirurgii

• Institute for Quality Control, University Hospital, Magdeburg

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Identifiers

DOI

10.2478/v10035-012-0024-1