Endoscopic Ultrasound Does Not Accurately Stage Early Adenocarcinoma or High-Grade Dysplasia of the Esophagus
Abstract
Patients with esophageal high grade dysplasia or mucosal esophageal cancer can he successfully treated hy endoscopy. We performed a systematic review of the literature to determine whether endoscopic ultrasound (EUS) correctly predicts the T-stage of early esophageal cancers, compared with pathology specimens obtained by using endoscopic mucosal resection (EMR) or surgery. METHODS: Standard systematic review methods were used w perform reference searches, determine eligibility, abstract data, and analyze data. \When possible, individual patient-level data were abstracted, in addition to publication- level aggregate data. RESULTS: Twelve studies had sufficient information to abstract and review for quality; 8 had individual patient-level data (n = 132). Compared with surgical or EMR pathology staging, EUS had T-stage concordance of 65%, including all studies (n = 12), but only 56% concordance when limited to individual patient-level data. Factors such as initial biopsy pathology (high-grade dysplasia vs early-stage cancer) did not appear to affect the concordance of staging between EUS and EMR/surgical staging. CONCLUSIONS: BUS is not sufficiently accurate in determining the T -stage of high-grade dysplasias or superficial adenocarcinomas; other means of staging, such as EMR, should be used.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2010
- Accession Number
- ADA551701
Entities
People
- Andrew B. Gentry
- Bruce D. Greenwald
- Mark S. Riddle
- Patrick E. Young
- Ruben D. Acosta
Organizations
- Naval Medical Research Center