title: Experience of endoscopic ultrasound in staging adenocarcinoma of the cardia.
abstract: OBJECTIVE
  The introduction of endoscopic ultrasonography (EUS) has generally resulted in a more accurate assessment of gastrointestinal regional tumour stage. Knowing the stage and the extent of oesophageal involvement is extremely important as a guide to the choice of surgical approach in cardia cancer. The aim of this study was to evaluate the ability of EUS to accurately predict depth of tumour invasion (T), node involvement (N) and the tumour's invasion length along the oesophagus.
  
  
  METHODS
  Thirty-five patients with adenocarcinoma of the cardia were studied by EUS and the EUS pre-operative findings were compared with the pathology findings.
  
  
  RESULTS
  The overall accuracy in T staging was 55.2% (16/29 cases). The sensitivity in evaluating T1, T2 and T3 classes was 80%, 38.5% and 70%, respectively. The sensitivity was excellent in evaluating N0 class (100%) (5 cases), but it fell to 66.7% in N1 cases. EUS correctly determined the extent of oesophagus invasion in 75.9% (22/29) of cases; moreover, it had a very high accuracy in distinguishing between tumours with an oesophageal invasion greater or lower than 2 cm (93.1%) (27/29 cases).
  
  
  CONCLUSIONS
  EUS proved to be useful in pre-operative staging of cardia adenocarcinoma and, in particular, in the pre-operative identification of the extent of oesophageal invasion.
authors.affiliation: 1st Division of General Surgery, University of Verona, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: de Manzoni
authors.forename: C
authors.initials: C
authors.lastname: Pedrazzani
authors.forename: A
authors.initials: A
authors.lastname: Di Leo
authors.forename: M
authors.initials: M
authors.lastname: Bonfiglio
authors.forename: P
authors.initials: P
authors.lastname: Tedesco
authors.forename: S
authors.initials: S
authors.lastname: Tasselli
authors.forename: G F
authors.initials: GF
authors.lastname: Veraldi
authors.forename: C
authors.initials: C
authors.lastname: Cordiano
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002299:Cardia; D004938:Esophageal Neoplasms / Q000556:secondary*; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods