Prognostic value of laparoscopic ultrasound in patients with gastro-esophageal cancer.
Forty-four patients with gastro-esophageal tumors regarded as resectable by conventional staging underwent laparoscopic ultrasonography (LUS). Following LUS, seven were found to be irresectable and were managed by palliative therapies. Thirty-seven patients proceeded to surgical exploration and 36 were resected (R0 80%, R1 11%, and R2 9%). All patients were reviewed until death or for a minimum of 24 months. Patients undergoing resection had a 62% 1-year survival (median 17 months; confidence intervals, CI 6-28). LUS defined nodal status indicated a trend toward prolonged survival in the node-negative group, median 22 months (CI 5-39), compared with 13 months (CI 6-20) in the node-positive group. Disease-free survival was greater in LUS node-negative patients at 29 months (CI 23-35) compared with node-positive patients at 13 months (CI 5-21) P=0.0083. LUS staging allows prediction of the likelihood of recurrence of gastro-esophageal malignancies. This may prove useful for the appropriate allocation of patients to primary and adjuvant therapies.
Flett
M E
ME
Department of Surgery, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK.
Lim
M N
MN
Bruce
D
D
Campbell
S H
SH
Park
K G
KG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D015331:Cohort Studies; D019160:Endosonography / Q000379:methods*; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D004943:Esophagogastric Junction / Q000473:pathology*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome