[Endoscopic ultrasound in the preoperative staging of gastric cancer: correlation with the surgical and/or pathological findings].
BACKGROUND
Gastric adenocarcinoma is the major cause of death by cancer in Brazil. For the planning of the treatment and evaluation of the prognosis, the preoperative staging according to the TNM classification is very important.


OBJECTIVE
To evaluate the results of endoscopic ultrasound for the T and N categories.


METHODS
We examined 30 patients with gastric adenocarcinoma in the period of 1 year. We used a Olympus GIF UM-20. After positioning in the third portion of the duodenum, we started to evaluate the lymph node stations 16, 13, 12, 6, 5, 4, 3, 8, 7, 9, 10, 11, 1 and 2, using the frequency of 7.5 MHz. The depth of the tumor in the gastric wall was evaluated with the frequencies of 7.5 and 12 MHz. The results T and N were compared with the conclusive findings. In the unresectable cases, the correlation was made by the macroscopic findings.


RESULTS
We performed 16 total gastrectomies, 7 subtotal gastrectomies, 5 exploratory laparotomies and 2 laparoscopies. For T category, endoscopic ultrasound results were correct in 25/30 cases (83.3%). All the other 16.7% were overestimated. The accuracy varied from 90% to 96.7% according to the subcategories T1 to T4. For the N category, endoscopic ultrasound results were correct in 23/30 cases (76.7%). Sixteen point six percent were underestimated and 6.7% overestimated. The accuracy varied from 76.7% to 90%, in agreement with the subcategories N1 to N3.


CONCLUSIONS
There was a clear correlation between endoscopic ultrasound and the surgical and pathological findings in the evaluation of T and N categories in patients with gastric adenocarcinoma.
Malheiros
Carlos Alberto
CA
Departamento de Cirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP.
Ardengh
José Celso
JC
Santo
Giulio Cesare
GC
Barata
Rita de Cássia Barradas
Rde C
Rahal
Fares
F
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery