A comparison of computerised tomography, laparoscopic ultrasound and endoscopic ultrasound in the preoperative staging of oesophago-gastric carcinoma

Wakelin, Sonia J.; Deans, Chris; Crofts, T. J.; Allan, Paul L.; Plevris, John; Paterson-Brown, Simon

doi:10.1016/s0720-048x(01)00418-1

Cited by 137 publications

(82 citation statements)

References 42 publications

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Section: Resultsmentioning

confidence: 99%

“…Fortynine studies (n = 2558) which met the inclusion criteria were included in this analysis [10,18,[20][21][22][23][24][38][39][40] . For T staging, there were 43 studies [10,18,[20][21][22][23][24] . There were 44 studies for nodal staging [10,18,[20][21][22][23][24][38][39][40][41][42][43][44][45][46][48][49][50]53,54,[56][57][58][59][60][61][62][63][66][67][68][69][70]…”

Section: Resultsmentioning

confidence: 99%

“…For T staging, there were 43 studies [10,18,[20][21][22][23][24] . There were 44 studies for nodal staging [10,18,[20][21][22][23][24][38][39][40][41][42][43][44][45][46][48][49][50]53,54,[56][57][58][59][60][61][62][63][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80] , and of these, 4 used FNA for nodal staging [23,…”

Section: Resultsmentioning

confidence: 99%

“…The accuracy of EUS to determine tumor depth has also been estimated to be quite accurate [18][19][20] . However, studies vary as to the accuracy of EUS in both the depth of local disease, nodal involvement, and the detection of distant metastases [21][22][23][24] . With EUS emerging as a very useful staging tool, its role in staging esophageal cancer continues to be addressed.…”

Section: Introductionmentioning

confidence: 99%

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Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

Puli¹,

Jb²,

Ml³

et al. 2008

WJG

331

191

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AIM:To evaluate the accuracy of endoscopic ultrasound (EUS) in the staging of esophageal cancer. METHODS:Only EUS studies confirmed by surgery were selected. Articles were searched in Medline and Pubmed. Two reviewers independently searched and extracted data. Meta-analysis of the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Pooling was conducted by both the Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran's Q test based upon inverse variance weights. RESULTS:Forty-nine studies (n = 2558) which met the inclusion criteria were included in this analysis. Pooled sensitivity and specificity of EUS to diagnose T1 was 81.6% (95% CI: 77.8-84.9) and 99.4% (95% CI: 99.0-99.7), respectively. To diagnose T4, EUS had a pooled sensitivity of 92.4% (95% CI: 89.2-95.0) and specificity of 97.4% (95% CI: 96.6-98.0). With Fine Needle Aspiration (FNA), sensitivity of EUS to diagnose N stage improved from 84.7% (95% CI: 82.9-86.4) to 96.7% (95% CI: 92.4-98.9). The P value for the χ 2 test of heterogeneity for all pooled estimates was > 0.10. CONCLUSION:EUS has excellent sensitivity and specificity in accurately diagnosing the TN stage of esophageal cancer. EUS performs better with advanced (T4) than early (T1) disease. FNA substantially improves the sensitivity and specificity of EUS in evaluating N stage disease. EUS should be strongly considered for staging esophageal cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

Puli¹,

Jb²,

Ml³

et al. 2008

WJG

331

191

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“…It is widely accepted that EUS has the highest accuracy for T and N staging of esophageal cancer [5]. EUS is regarded as superior to CT in this regard and is thought to be more accurate for evaluation of resectability [11][12][13][14][15]. However, randomized trials comparing the clinical impact of staging protocols with and without EUS have not been performed.…”

Section: Discussionmentioning

confidence: 99%

Low impact of staging EUS for determining surgical resectability in esophageal cancer

et al. 2012

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Background Although studies have shown that EUS has a high sensitivity and specificity for T and N staging, the value of EUS for staging tumors as resectable or nonresectable after CT of the chest and abdomen and US neck assessment, is largely unknown. This study was designed to assess the diagnostic value of EUS for determining resectability of esophageal cancer. Methods A retrospective analysis of all consecutive patients with esophageal carcinoma who underwent staging EUS, CT, and US. Tumors were considered resectable when there was no evidence of metastases or ingrowth in adjacent structures. Sensitivity, specificity, positive (PPV), and negative (NPV) predictive value of CT/US neck and CT/US neck ? EUS for predicting surgical resectability were calculated. PPVs of CT/US alone and CT/US ? EUS together were compared for assessing the diagnostic value of EUS. Results In total, 211 patients (155 men; mean age of 64 ± 9.4 years) were included, of which 176 (83 %) underwent all three staging investigations. Based on preoperative staging, 173 (82 %) patients were considered resectable and 38 (18 %) nonresectable. Of all 173 initially resectable patients, 145 were operated on. Of these patients, five (3.4 %) tumors were found nonresectable during surgery. Postoperative sensitivity, specificity, PPV, and NPV of CT/US and CT/US ? EUS for predicting surgical resectability were 88 versus 87 %, 20 versus 40 %, 97 versus 98 %, and 6 versus 10 %, respectively. Conclusions Although EUS adds to the specificity of preoperative esophageal cancer staging after CT chest and abdomen, and US of the neck have been performed, the overall added value of EUS is limited. Keywords Esophageal cancer Á Endoscopic ultrasonography Á Surgical resectabilityApproximately 50 % of patients with esophageal cancer present with potentially resectable disease [1]. Current guidelines recommend computed tomography (CT) of the chest and abdomen, ultrasonography (US) of the neck, and endoscopic ultrasonography (EUS) for staging of esophageal cancer [2][3][4]. Although CT of the chest and abdomen and US of the neck are primarily used for the detection of distant metastases, EUS provides information on local resectability (T stage) and locoregional lymphadenopathy (N stage) [5,6].One of the main goals of esophageal cancer staging is to select patients who are suitable for surgical resection of the tumor, because surgery remains the best curative option for

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The Value of Laparoscopic Staging for Patients With Colorectal Metastases

Metcalfe

Close²,

Iswariah³

et al. 2003

Arch Surg

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Background: Resection offers the only chance of cure for hepatic colorectal metastases. However, preoperative staging does not always reliably detect unresectable disease. The aim of this study was to investigate the role that laparoscopy with ultrasound may have in detecting unresectable disease, thus sparing patients from unnecessary laparotomy with the associated morbidity and cost. Methods: A retrospective review of all patients considered for liver resection of colorectal metastases during a 3-year period was performed, analyzing factors likely to predict resectable disease, rates of resectability, and success of laparoscopic staging at detecting unresectable disease. Results: Of 73 patients with resectable disease on computed tomography, 24 were deemed to need laparos

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A comparison of computerised tomography, laparoscopic ultrasound and endoscopic ultrasound in the preoperative staging of oesophago-gastric carcinoma

Cited by 137 publications

References 42 publications

Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

Staging accuracy of esophageal cancer by endoscopic ultrasound: A meta-analysis and systematic review

Low impact of staging EUS for determining surgical resectability in esophageal cancer

The Value of Laparoscopic Staging for Patients With Colorectal Metastases

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