Comparison of endoscopic ultrasonography and multislice spiral computed tomography for the preoperative staging of gastric cancer - results of a single institution study of 610 Chinese patients.
BACKGROUND
This study compared the performance of endoscopic ultrasonography (EUS) and multislice spiral computed tomography (MSCT) in the preoperative staging of gastric cancer.


RESULTS
A total of 610 patients participated in this study, all of whom had undergone surgical resection, had confirmed gastric cancer and were evaluated with EUS and MSCT. Tumor staging was evaluated using the Tumor-Node-Metastasis (TNM) staging and Japanese classification. The results from the imaging modalities were compared with the postoperative histopathological outcomes. The overall accuracies of EUS and MSCT for the T staging category were 76.7% and 78.2% (P=0.537), respectively. Stratified analysis revealed that the accuracy of EUS for T1 and T2 staging was significantly higher than that of MSCT (P<0.001 for both) and that the accuracy of MSCT in T3 and T4 staging was significantly higher than that of EUS (P<0.001 and 0.037, respectively). The overall accuracy of MSCT was 67.2% when using the 13th edition Japanese classification, and this percentage was significantly higher than the accuracy of EUS (49.3%) and MSCT (44.6%) when using the 6th edition UICC classification (P<0.001 for both values).


CONCLUSIONS
Our results demonstrated that the overall accuracies of EUS and MSCT for preoperative staging were not significantly different. We suggest that a combination of EUS and MSCT is required for preoperative evaluation of TNM staging.
State Key Laboratory of Oncology in South China, Guangzhou, China ; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
Xing-Yu
XY
Feng
Wei
W
Wang
Guang-Yu
GY
Luo
Jing
J
Wu
Zhi-Wei
ZW
Zhou
Wei
W
Li
Xiao-Wei
XW
Sun
Yuan-Fang
YF
Li
Da-Zhi
DZ
Xu
Yuan-Xiang
YX
Guan
Shi
S
Chen
You-Qing
YQ
Zhan
Xiao-Shi
XS
Zhang
Guo-Liang
GL
Xu
Rong
R
Zhang
Ying-Bo
YB
Chen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002681:China; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods*; D057234:Preoperative Period; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000208:ethnology / Q000473:pathology* / Q000601:surgery; D055815:Young Adult