title: Endosonographic tumor staging for treatment decision in resectable gastric cancer.
abstract: OBJECTIVE
  Neoadjuvant preoperative chemotherapy is the standard of care in locally advanced resectable gastric cancer. Therefore, accurate locoregional staging is essential for treatment decision. EUS is believed to be the most performant diagnostic method for locoregional staging. However, it is questionable, if results from centers of excellence can be maintained in clinical routine.
  
  
  METHODS
  We retrospectively analyzed the data of 62 resectable gastric cancers staged by EUS during routine clinical work-up. Preoperative variables (tumor size and site, histological differentiation) were compared with the postoperative pathology.
  
  
  RESULTS
  19 locally limited (T1-2, N0), and 43 locally advanced (T3-4, or N+ irrespective of T stage) were analyzed. The sensitivity of EUS for the detection of locally advanced disease was 93%, with a specificity of 78%.
  
  
  CONCLUSIONS
  Even in daily routine practice, differentiation of locally limited and advanced disease with EUS can be performed with high sensitivity and good specificity. Therefore, EUS is an essential part of the diagnostic procedure in patients with gastric cancer.
authors: Department of Gastroenterology, Katharinenhospital, Klinicum Stuttgart, D-70174 Stuttgart, Germany. w.bohle@klinikum-stuttgart.de
authors: Wolfram
authors: W
authors: Bohle
authors: Alexander
authors: A
authors: Scheidig
authors: Wolfram G
authors: WG
authors: Zoller
mesh_terms: D017024:Chemotherapy, Adjuvant; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery