Endoscopic ultrasound versus multidetector computed tomography in preoperative gastric cancer staging

Rev Esp Enferm Dig. 2017 Nov;109(11):761-767. doi: 10.17235/reed.2017.4638/2016.

Abstract

Introduction: Endoscopic ultrasonography (EUS) is the gold standard technique in loco-regional staging of gastric adenocarcinoma (GAC). Nevertheless, the introduction of multidetector-row computed tomography (MDCT) allows accurate studies to be performed.

Objective: To compare the diagnostic yield of EUS and MDCT in loco-regional preoperative staging of gastric adenocarcinoma.

Material and methods: This was a retrospective and comparative study of all surgical patients with GAC and preoperative staging by EUS and 64-row MDCT. The results for each case were compared with the histological data.

Results: Seventy seven surgical patients with GAC were identified and forty two had a complete preoperative staging and were finally included in the study. With regard to overall accuracy of T staging, EUS was superior to MDCT (62% vs 50%). In a subanalysis of early stages (T1-T2) and advanced stages (T3-T4), accuracy and sensitivity (S) were higher for EUS than for MDTC (83.3% vs 64.29% and 84.4% vs 59.5% respectively), although this did not reach statistical significance. The overall accuracy and sensitivity of EUS for N staging was lower than that for MDCT, although neither comparison reached statistical significance (57% vs 64% and 29% vs 55%).

Conclusion: EUS diagnostic yield is similar to new MDCT with regard to T and N preoperative staging of GAC. Nevertheless, both techniques should be considered as complementary until more extensive and randomized studies can confirm these results.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Endosonography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Neoplasm Staging / methods*
  • Preoperative Care
  • Reproducibility of Results
  • Retrospective Studies
  • Stomach Neoplasms / diagnostic imaging*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery