ENDOSCOPIC ULTRASONOGRAPHY FOR PREOPERATIVE LOCOREGIONAL STAGING AND ASSESSMENT OF RESECTABILITY IN GASTRIC-CANCER

We performed a prospective study from November 1989 to December 1996 t o assess the accuracy of endoscopic ultrasonography (EUS) in the locor egional staging and resectability of patients with gastric carcinoma. One hundred and nineteen patients with gastric cancer who received pre operative assessment by EUS underwent subsequent surgery. The endosono graphic tumor-node-metastasis (TNM) classification was used for compar ison with the histopathologic findings of the resected specimens. The ability of EUS to accurately predict the T stage (depth of tumor invas ion) and N stage (involvement of lymph node) was 70% and 65%, respecti vely. EUS displayed a tendency to overestimate T stage and underestima te N stage. The differentiation of early gastric cancer from advanced gastric cancer showed a concordance rate of 89% with an overestimation rate of 8% and underestimation rate of 3%. The accuracy of EUS in pre dicting the stage T1 to T3, which correspond to DO resectability (no m acroscopic or microscopic tumor remains), tvas 91%. In conclusion, the se results revealed EUS as a valuable tool for evaluating the local st aging and resectability of gastric cancer. We suggest that EUS should be introduced in the preoperative assessment of patients with gastric cancer. (C) Elsevier Science Inc., 1998.