Systematic review of the impact of endoscopic ultrasound on the management of patients with esophageal cancer

Dyer, Suzanne M; Levison, Dane B.; Chen, Robert Y.; Lord, Sarah J.; Blamey, Stephen

doi:10.1017/s026646230708004x

Cited by 14 publications

(6 citation statements)

References 23 publications

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“…5,6,[15][16][17][18] Compared to T1N0 tumors, creased depth of invasion. [19][20][21] Together, this makes the controversial treatment algorithm of cT2 even more complicated. Abbreviations: CI, confidence interval; HR, hazard ratio.…”

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confidence: 99%

Inaccurate pretreatment staging can impact survival in early stage esophageal adenocarcinoma

Scholer

Uppal

Chang

et al. 2020

Journal of Surgical Oncology

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Background Given the survival advantage of neoadjuvant treatment for locally advanced esophageal cancer, accurate clinical staging is necessary. The aim of this study was to assess the clinical (c) and pathologic (p) staging concordance rates for presumably early stage esophageal adenocarcinoma patients that had upfront esophagectomy (UFE) and evaluate if survival (OS) was negatively affected by inaccurate preoperative staging and subsequent treatment selection. Methods An NCDB retrospective review of nonmetastatic esophageal adenocarcinoma patients that had UFE. The rates of concordance between c and p staging system and OS were calculated. Results Of 2775 patients, most patients presented with cN0 (82.8%) and cT1 tumors (53.6%). The overall concordance between c and p staging was 78.8% for T‐classification (moderate agreement; weighted κ = 0.729; P < .001) and 78.8% for N‐classification (weak agreement; weighted κ = 0.448; P < .001). Patients that were upstaged due to a lack of concordance between T‐classification had decreased 5‐ and 10‐year OS (30% and 16%, P < .001) and those upstaged due to discordant N‐classification had decreased 5‐ and 10‐year OS (28% and 23%, P < .001).” Conclusions Preoperative staging of esophageal adenocarcinoma has moderate reliability and accuracy for predicting pT and pN classification. Up to 25% of patients have discordant clinical and pathological staging, which impacts OS.

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confidence: 99%

Inaccurate pretreatment staging can impact survival in early stage esophageal adenocarcinoma

Scholer

Uppal

Chang

et al. 2020

Journal of Surgical Oncology

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“…[4][5][6][7][8] In concert with the rising burden of gastrointestinal and hepatobiliary conditions in Canada and elsewhere, [9][10][11][12] the applications of interventional endoscopic ultrasonography continue to increase and currently include drainage of pancreatic fluid collection, biliary drainage, celiac plexus nerve blockade and radiologic placement of fiducial markers. 13 Multiple investigations have shown that endoscopic ultrasound evaluation can alter patient management in up to 74% of cases, including those of gallstone disease or pancreatitis as well as esophageal, pancreatic, stomach and rectal cancers. For most patients, endoscopic ultrasound evaluation leads to less invasive and costly treatments.…”

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confidence: 99%

“…For most patients, endoscopic ultrasound evaluation leads to less invasive and costly treatments. [13][14][15][16] Single-and multicentre studies have shown an increase in the application of endoscopic ultrasonography over time; 17,18 however, these findings may not be generalizable to broader populations. Furthermore, little is known about regional Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study trends in use.…”

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Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study

et al. 2017

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Background: Endoscopic ultrasonography is a safe and accurate modality for evaluating and managing hepatobiliary and gastrointestinal conditions (malignant and nonmalignant); its use is increasing. The aim of this study was to describe regional trends in the use of endoscopic ultrasonography in Ontario. Methods:We conducted a population-based retrospective cohort study using health administrative databases. We identified all patients who underwent an endoscopic ultrasound procedure in Ontario from 2003 to 2011 using physician billing data. Patient, physician and institution characteristics were examined. The primary outcome was use of endoscopic ultrasonography. Results:We identified 9076 endoscopic ultrasound procedures performed in 8001 patients (3858 women [48.2%]; median patient age at first procedure 59 years). A total of 3066 procedures (33.8%) involved fine-needle aspiration. Use of endoscopic ultrasonography increased 17-fold over the study period. In 2011, people living in the health region with the highest rate of use of endoscopic ultrasonography were more than 4 times more likely to undergo the procedure than people living in the health region with the lowest rate of use (standardized rate 61.6 v. 12.9 per 100 000). About 7 in 10 endoscopic ultrasound procedures were performed in an academic institution or regional cancer centre. All 17 endoscopists performing endoscopic ultrasonography during the study period practised in urban areas.Interpretation: Although the use of endoscopic ultrasonography increased over time in Ontario, there were marked regional differences in use. Provincial needs-and evidence-based initiatives may be needed to narrow the regional gaps in provision of endoscopic ultrasound services in the province. AbstractResearch Research CMAJ OPEN E438CMAJ OPEN, 5(2)

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“…Again, however, there are few studies examining the effect of EUS staging on subsequent management. In their systematic review, Dyer et al 105 acknowledged that drawing conclusions from observational studies, rather than RCTs, was open to bias, but estimated that EUS appeared to change management in 24-29% of patients. Two retrospective, 106,107 and therefore suspect, studies examined the effect of EUS staging on patient survival.…”

Section: Influence Of Endoscopic Ultrasound On Managementmentioning

confidence: 99%

Cancer of Oesophagus or Gastricus – New Assessment of Technology of Endosonography (COGNATE): report of pragmatic randomised trial

Russell

Edwards²,

Gliddon³

et al. 2013

Health Technol Assess

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Systematic review of the impact of endoscopic ultrasound on the management of patients with esophageal cancer

Cited by 14 publications

References 23 publications

Inaccurate pretreatment staging can impact survival in early stage esophageal adenocarcinoma

Inaccurate pretreatment staging can impact survival in early stage esophageal adenocarcinoma

Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study

Cancer of Oesophagus or Gastricus – New Assessment of Technology of Endosonography (COGNATE): report of pragmatic randomised trial

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