Open AccessSurgically resected T1‐ and T2‐stage esophageal squamous cell carcinoma: T and N staging performance of EUS and PET / CT
Author(s) -
Jeong Dong Young,
Kim Min Yeong,
Lee Kyung Soo,
Choi Joon Young,
Kim Soo Jeong,
Chung Myung Jin,
Min Yang Won,
Kim Hong Kwan,
Zo Jae Ill,
Shim Young Mog,
Sun JongMu
Publication year - 2018
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1617
Subject(s) - medicine , stage (stratigraphy) , endoscopic ultrasonography , esophageal squamous cell carcinoma , t stage , radiology , esophageal cancer , diagnostic accuracy , carcinoma , nuclear medicine , cancer , endoscopy , paleontology , biology
This study aimed to evaluate the frequency of nodal metastases and to disclose the diagnostic performance of endoscopic ultrasonography (EUS) and PET/CT in T and N staging in surgically resected early‐stage esophageal squamous cell carcinomas (eSCCs). Institutional review board approved this retrospective study with waiver of informed consent for reviewing medical record. We included 435 patients with an early T‐stage (Tis or T1a [≤T1a], T1b and T2) eSCC . The rates of metastatic lymphadenopathy were calculated. Then, the performance of EUS and PET / CT in subdividing T and N stages was assessed. 131 ≤ T1a, 234 T1b, and 70 T2 eSCC s were identified. In discriminating ≤T1a from other cancers, the sensitivity, specificity, and accuracy of EUS were 60.3% (79/131), 80.3% (244/304), and 74.3% (323/435) respectively. With ROC curve analysis, cut‐off value of SUV max 3.05 at PET provided sensitivity 74.8% (98/131), specificity 70.1% (213/304), and accuracy 71.5% (311/435) for differentiating ≤T1a eSCC s from others. Ten (7.6%) of 131 ≤ T1a cancers had nodal metastasis. In discriminating N0 from node‐positive disease, sensitivity, specificity, and accuracy of EUS were 89.6% (267/298), 41.6% (57/137), and 74.5% (324/435), respectively, whereas those of PET / CT were 88.9% (265/298), 38.7% (53/137), and 73.1% (318/435) respectively. In >70% of patients with ≤T1a eSCC s, the tumor stage can be discriminated from higher stage cancers by using EUS or PET / CT . Substantial percentage (7.6%) of ≤T1a eSCC patients have nodal metastases, which are missed in more than half of the patients in clinical staging.