Video-endoscopic ultrasonography in staging gastric carcinoma

Background/Aims: Clinical staging of gastric carcinoma is important in desi gning the strategy of treatment. Early gastric carcinomas can be treated by minimally invasive therapy, whereas advanced gastric carcinomas should be treated by surgery with or without combined chemotherapy. This study was un dertaken to evaluate the accuracy and limitations of video type endoscopic ultrasound in preoperative staging of gastric cancer and assessing lymph no de metastasis. Methodology: Seventy-four patients with gastric carcinoma were preoperative ly staged using video-endoscopic ultrasonography, performed by the same gas troenterologist. Results: Sixty-three out of the 74 (85%) patients were correctly staged by endoscopic ultrasonography. The diagnostic accuracy rate was 100% for T1, 7 4% for T2, 87% for T3, and 86% for T4. Overstaging occurred in 11% due to p eritumoral inflammation. Understaging occurred in 49 due to microinvasion o f carcinomatous tissue or deeper organ invasion. The diagnosis of lymph nod e metastasis was confirmed in 72% of cases. Sensitivity and specificity was 74% and 86%, respectively. Conclusions: Endoscopic ultrasonography has a high accuracy rate in staging gastric carcinoma but still has its limitations in evaluating regional lym ph node metastasis, despite using a new generation video-endoscopic ultraso nography.