Endoscopic ultrasound in gastric cancer staging before and after neoadjuvant chemotherapy. A comparison with PET‐CT in a clinical series

Redondo–Cerezo, Eduardo; Martínez-Cara, Juan Gabriel; Jiménez-Rosales, Rita; Valverde-López, Francisco; Caballero-Mateos, Antonio M.; Jérvez-Puente, Pablo; Ariza-Fernández, José Luis; Úbeda-Muñoz, Margarita; López-de-Hierro, Mercedes; Teresa, J. De

doi:10.1177/2050640616684697

Cited by 32 publications

(20 citation statements)

References 26 publications

(71 reference statements)

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“…Many studies have been conducted with evaluating the accuracy of EUS in gastric cancer staging and some of them have reported that EUS is useful in determining the invasion depth (T stage) with an accuracy higher than 90%. EUS performance for N stage evaluation seems to be less effective than T stage evaluation, although previous studies have shown excellent accuracy of nodal stage evaluation by EUS 13–27 . These data suggest that EUS is an excellent adjunct to standard staging modalities in gastric cancer.…”

Section: Introductionmentioning

confidence: 71%

“…3 Nonetheless there is great heterogeneity in the accuracy rates of T and N stages, with reports ranging between 60-90% for T stage and 50-90% for N stage. 3,[11][12][13]15,17,[19][20][24][25][26][27] In contrast with previous studies focusing on T and N stage evaluation separately, we have evaluated T and N in combination in this study, focusing on the distinction between T1N0 and T ! 2 and/or Nþ tumours, which is more clinically applicable.…”

Section: Discussionmentioning

confidence: 99%

“…EUS has been increasingly used as an image modality in this setting due to its superior ability to assess the depth of invasion (T stage) and lymph node involvement (N stage) 3 . Nonetheless there is great heterogeneity in the accuracy rates of T and N stages, with reports ranging between 60–90% for T stage and 50–90% for N stage 3 , 11–13 , 15 , 17 , 19–20 , 24–27 …”

Section: Discussionmentioning

confidence: 99%

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Accuracy of endoscopic ultrasound in gastric adenocarcinoma patient selection for neoadjuvant therapy

et al. 2019

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Background: Recent studies demonstrated the positive impact of neoadjuvant treatment in locally advanced gastric cancer. Objective: To assess the accuracy of endoscopic ultrasound (EUS) in the selection of patients with gastric adenocarcinoma for neoadjuvant therapy (T ! 2 and/or Nþ). Methods: Retrospective analysis of patients with an anatomopathological diagnosis of gastric adenocarcinoma between January 2011 and June 2017, who had EUS for staging and underwent surgery as a first therapeutic attempt. The concordance (k) and accuracy (area under the curve (AUC)) of EUS for T ! 2 and/or Nþ were assessed using the anatomopathological staging of the resected surgical specimen as the gold standard. Results: The final sample included 152 patients (66.4% male, 67.1 AE 12.2 years). The concordance, accuracy, sensitivity and specificity of the EUS for T ! 2 and/or Nþ were 0.72, 0.86 AE 0.03, 88.5% and 83.1%, respectively. The results were higher in proximal (k ¼ 0.93, AUC ¼ 0.96 AE 0.05, sensitivity (S) ¼ 99.0% and specificity (E) ¼ 90.9%) compared with distal lesions (k ¼ 0.67, AUC ¼ 0.84 AE 0.04, S ¼ 85.7% and E ¼ 81.5%), and in intestinal subtype (k ¼ 0.77, AUC ¼ 0.88 AE 0.04, S ¼ 92.6% and E ¼ 84.1%) compared with diffuse (k ¼ 0.58, AUC ¼ 0.79 AE 0.10, S ¼ 85.0% and E ¼ 72.7%) or mixed-subtype tumours (k ¼ 0.65, AUC ¼ 0.84 AE 0.10, S ¼ 76.9% and E ¼ 90.0%). Conclusion: In one of the largest series of patients, we showed that EUS has overall high agreement and accuracy in the selection of patients with gastric adenocarcinoma for neoadjuvant therapy, although the agreement and accuracy are greater for proximal and intestinal lesions.

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Section: Introductionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Accuracy of endoscopic ultrasound in gastric adenocarcinoma patient selection for neoadjuvant therapy

et al. 2019

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“… 35 With the development of endoscopic technology, endoscopic ultrasound (EUS) has received increasing attention. Redondo et al 36 believe that EUS has advantages over CT and positron emission tomography, especially in T1-T2 stage.…”

Section: Efficacy Prediction and Evaluationmentioning

confidence: 99%

Neoadjuvant therapy strategies for advanced gastric cancer: Current innovations and future challenges

Zhu

Gong

2020

Chronic Diseases and Translational Medicine

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Gastric cancer, which has a high incidence and poor prognosis, remains a therapeutic challenge. Recently, neoadjuvant therapy has attracted increasing attention due to high recurrence rate and low survival rate after resection in most patients with advanced stage. Clinical trials show that neoadjuvant approaches confer a significant survival advantage for resectable locally advanced gastric cancer. The specific advantages of chemoradiotherapy compared with chemotherapy have not been clarified; optimal regimens and cycles, particularly in the preoperative setting, should be studied further; and trials aimed at determining the role of targeted and immunological therapies should be conducted.

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“…In the most cited studies in this field, data about further interventions depending on EUS findings, or long-term follow ups for relapse detection, are lacking [14,15]. Furthermore, echoendoscope image quality has significantly improved and, in more recent studies, it has shown better results than in earlier series [16]. Moreover, new criteria for chronic pancreatitis have been developed [17], so that the current diagnostic yield of EUS in the evaluation of IAP may have improved.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound as a diagnostic and predictive tool in idiopathic acute pancreatitis

Valverde-López¹,

Ortega-Suazo²,

Wilcox

et al. 2020

aog

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Background Endoscopic ultrasound (EUS) is useful in the diagnostic workup of idiopathic acute pancreatitis but its role as a predictor of recurrence has not been thoroughly assessed. Our aim was to study the performance of EUS in idiopathic acute pancreatitis, its impact on the natural history of the disease, and the factors related to recurrence. Methods Patients with idiopathic acute pancreatitis referred to our endoscopy unit were enrolled and followed, with assessment of the performance of endoscopic retrograde cholangiopancreatography (ERCP), cholecystectomy, and the incidence of recurrence. EUS findings and recurrence rates were compared between patients with a first episode or recurrent attacks and in patients with previous cholecystectomy versus those with gallbladder in situ. Results One hundred six patients were included (mean follow up: 53.59±27.79 months). Biliary disease related to stones was the most common finding on EUS (49.1%), and patients referred for recurrent attacks showed the highest recurrence rate during follow up (57.1%). ERCP or cholecystectomy reduced recurrences to 14.3% in patients with biliary disease. Age under 65 (odds ratio [OR] 3.56, 95% confidence interval [CI] 1.21-10.44; P=0.02), previous cholecystectomy (OR 3.19, 95%CI 1.11-9.17; P=0.03), and no lithiasis on EUS (OR 2.87, 95%CI 1.04-7.87; P=0.04) were independent risks factors for recurrence. Conclusions EUS-directed ERCP/cholecystectomy was associated with lower relapse rates in idiopathic acute pancreatitis. Along with age and gallbladder status, it provides predictive information about recurrence likelihood.

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Endoscopic ultrasound in gastric cancer staging before and after neoadjuvant chemotherapy. A comparison with PET‐CT in a clinical series

Abstract: EUS performed better than PET-CT in gastric cancer N staging and restaging. EUS accuracy in this setting is still suboptimal and probably more than one single diagnostic procedure should be used.

Cited by 32 publications

References 26 publications

Accuracy of endoscopic ultrasound in gastric adenocarcinoma patient selection for neoadjuvant therapy

Accuracy of endoscopic ultrasound in gastric adenocarcinoma patient selection for neoadjuvant therapy

Neoadjuvant therapy strategies for advanced gastric cancer: Current innovations and future challenges

Endoscopic ultrasound as a diagnostic and predictive tool in idiopathic acute pancreatitis

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