Document Detail

Preoperative assessment of tumor location and station-specific lymph node status in patients with adenocarcinoma of the gastroesophageal junction.
MedLine Citation:
PMID:  23015224     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In esophageal cancer patients preoperative staging will determine the type of surgical procedure and use of neoadjuvant therapy. Tumor location and lymph node status play a pivotal role in this tailored strategy. The aim of the present study was to prospectively evaluate the accuracy of preoperative assessment of tumor location according to the Siewert classification and lymph node status per station with endoscopy/endoscopic ultrasound (EUS) and computed tomography (CT).
METHODS: In 50 esophagectomy patients with adenocarcinoma of the gastroesophageal junction (GEJ), tumor location according to Siewert and N-stage per nodal station as determined preoperatively by endoscopy/EUS and CT were compared with the histopathologic findings in the resection specimen.
RESULTS: Overall accuracy in predicting tumor location according to the Siewert classification was 70 % for endoscopy/EUS and 72 % for CT. Preoperative data could not be compared with the pathologic assessment in 11 patients (22 %), as large tumors obscured the landmark of the gastric folds. The overall accuracy for predicting the N-stage in 250 lymph node stations was 66 % for EUS and 68 % for CT. The accuracy was good for those stations located high in the thorax, but poor for celiac trunk nodes.
CONCLUSIONS: Given the frequent discrepancy between the endoscopic and pathologic location of the GEJ and the common problem of advanced tumors obscuring the landmarks used in the assessment of the Siewert classification, its usefulness is limited. The overall accuracy for EUS and CT in predicting the N-stage per station was moderate.
Brechtje A Grotenhuis; Bas P L Wijnhoven; Jan Werner Poley; John J Hermans; Katharina Biermann; Manon C W Spaander; Marco J Bruno; Hugo W Tilanus; J Jan B van Lanschot
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  37     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-05-28     Revised Date:  2013-10-02    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-55     Citation Subset:  IM    
Department of Surgery, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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MeSH Terms
Adenocarcinoma / pathology*,  secondary*,  surgery
Aged, 80 and over
Esophageal Neoplasms / pathology*,  surgery
Esophagogastric Junction / pathology*
Lymphatic Metastasis
Middle Aged
Preoperative Care
Prospective Studies
Stomach Neoplasms / pathology*,  surgery
Comment In:
Chirurg. 2013 Aug;84(8):699   [PMID:  23760394 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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