Document Detail


Is positron emission tomography useful in locoregional staging of esophageal cancer? Results of a multidisciplinary initiative comparing CT, positron emission tomography, and EUS.
MedLine Citation:
PMID:  18178202     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Various modalities including CT, positron emission tomography (PET), and EUS are being used for esophageal cancer staging. OBJECTIVE: We compared results of locoregional staging by CT, PET, and EUS with histologic staging. DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS AND INTERVENTIONS: Patients with esophageal cancer proven by endoscopy and biopsy underwent a CT scan of the chest and abdomen and a PET scan. Patients with no evidence of distant metastatic disease on CT and PET were referred for EUS for locoregional staging. MAIN OUTCOME MEASUREMENT: The tumor size (T) and lymph node (N) stage as determined by EUS were compared with surgical pathology or EUS-guided FNA cytology. The results of N staging with CT, PET, and EUS were compared with surgical pathology or EUS-FNA cytology. RESULTS: Between May 2005 and April 2006, 29 patients (24 men, mean age 68 years) underwent EUS. EUS was successful in 25 of 29 patients (86%). There were no EUS-related complications. Eleven of 16 patients with available lymph node histologic study had confirmed metastasis. Nodal metastasis was correctly identified by CT in 6 of 11 patients, by PET in 4 of 11 patients, and by EUS in 10 of 11 patients. Overall accuracy for N staging was 69% for CT, 56% for PET, and 81% for EUS. Fifteen patients had confirmed T staging by surgical pathologic examination. The percentage of agreement for T staging between EUS and surgical pathology was 80% (12/15 patients). LIMITATIONS: Single center, retrospective chart review. CONCLUSION: EUS is safe and accurate for tumor and node staging in esophageal cancer. The combination of CT plus EUS appears to be accurate for locoregional staging in esophageal cancer.
Authors:
Gurpal Singh Sandha; Diane Severin; Ernst Postema; Alexander McEwan; Ken Stewart
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  67     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-25     Completed Date:  2008-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  402-9     Citation Subset:  IM    
Affiliation:
Current affiliations: Department of Medicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Carcinoma / diagnosis*,  therapy
Cohort Studies
Endosonography*
Esophageal Neoplasms / diagnosis*,  therapy
Female
Humans
Male
Middle Aged
Neoplasm Staging
Positron-Emission Tomography*
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Tomography, X-Ray Computed*

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


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