Endoscopic ultrasound for staging of colonic cancer proximal to the rectum: A systematic review and meta-analysis.
OBJECTIVE
Treatment of colonic cancer patients is highly dependent on the depth of tumor invasion (T-stage) as well as the extension of lymph node involvement (N-stage). We aimed to systematically review the accuracy of endoscopic ultrasound (EUS) for staging of colonic cancer proximal to the rectum.


METHODS
Men and women with colonic adenocarcinomas were included in the study. EUS staging was compared to histopathology as the gold standard. Outcome measures were T- and N-staging accuracies. Articles were searched in PubMed, Web of Science, The Cochrane Library, and EMBASE.


RESULTS
Six studies were identified comparing EUS staging of colonic cancer to histopathology. The pooled-staging sensitivity and specificity were 0.90 and 0.98 for T1 tumors, 0.67 and 0.96 for T2 tumors, and 0.97 and 0.83 for T3/T4 tumors, respectively. Sensitivity and specificity forN+ disease were 0.59 and 0.78, respectively.


CONCLUSIONS
EUS is a feasible method for T-staging of cancers of the colon proximal to the rectum. The accuracy of lymph node staging needs to be verified by prospective multicenter studies including larger patient populations.
Department of Surgery, Endoscopy Unit, Herlev University Hospital, Herlev, Denmark, Romania.
Marie Louise
ML
Malmstrøm
Department of Surgery, Endoscopy Unit, Herlev University Hospital, Herlev, Denmark, Romania; Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Adrian
A
Săftoiu
Department of Surgery, Endoscopy Unit, Herlev University Hospital, Herlev, Denmark, Romania.
Peter
P
Vilmann
Department of Haematology, Herlev University Hospital, Herlev, Denmark, Romania.
Tobias Wirenfeldt
TW
Klausen
Department of Surgery, Zealand University Hospital, University of Copenhagen, Køge, Denmark, Romania.
Ismail
I
Gögenur
Colonic cancer; endoscopic ultrasound; staging; systematic review