COMPUTED-TOMOGRAPHY, ENDOSCOPIC ULTRASONOGRAPHY AND INTRAOPERATIVE ASSESSMENT IN TN STAGING OF GASTRIC-CARCINOMA

Citation
Ds. Perng et al., COMPUTED-TOMOGRAPHY, ENDOSCOPIC ULTRASONOGRAPHY AND INTRAOPERATIVE ASSESSMENT IN TN STAGING OF GASTRIC-CARCINOMA, Journal of the Formosan Medical Association, 95(5), 1996, pp. 378-385
Citations number
34
Categorie Soggetti
Medicine, General & Internal
ISSN journal
09296646
Volume
95
Issue
5
Year of publication
1996
Pages
378 - 385
Database
ISI
SICI code
0929-6646(1996)95:5<378:CEUAIA>2.0.ZU;2-E
Abstract
In a prospective study from November 1989 to December 1993, the accura cy of computed tomography (CT), endoscopic ultrasonography (EUS) and i ntraoperative surgical assessment were compared for the evaluation of the depth of invasion (T category) and involvement of lymph nodes (N c ategory in patients with gastric carcinoma. Sixty-nine consecutive pat ients who received preoperative CT and EUS underwent subsequent surger y. CT and EUS results were compared with histopathologic staging of tu mor invasion depth and regional lymph node metastasis (pT and pN categ ories). T categories were staged correctly in 42% of the cases by CT, 71% by EUS and 55% by intraoperative surgical assessment. CT correctly staged 49% of N1 and N2 lymph nodes compared with 65% for EUS and 45% for intraoperative surgical assessment. CT was more accurate for adva nced cancer but had a tendency to understage the T and N categories. E US was more accurate for serosal cancer and displayed a tendency to ov erstage T categories and understage N categories. Intraoperative surgi cal assessment overstaged early T stages, understaged the T4 stage and had a tendency to overstage N categories. CT and intraoperative surgi cal assessment of T and N categories were of limited value in the stag ing of gastric carcinoma compared to EUS. EUS is a valuable form of as sessment to evaluate gastric cancer staging before surgery.