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
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.