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Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer
Author(s) -
Ahn Hye Seong,
Lee HyukJoon,
Yoo MoonWon,
Kim Sang Gyun,
Im Jong Pil,
Kim Se Hyung,
Kim Woo Ho,
Lee Kuhn Uk,
Yang HanKwang
Publication year - 2008
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21170
Subject(s) - medicine , esophagogastroduodenoscopy , endoscopic ultrasonography , stage (stratigraphy) , endoscopic ultrasound , radiology , endoscopy , stomach , cancer , t stage , gastrectomy , lymph node , upper endoscopy , paleontology , biology
Background Preoperative accurate diagnosis of the T and N stages in early gastric cancer (EGC) is important in determining the application of various limited treatments. The aim of this study is to analyze the accuracy of T and N staging of EGC with esophagogastroduodenoscopy (EGD), Stomach protocol CT (S‐CT), and endoscopic ultrasonography (EUS), and the factors influencing the accuracy. Methods Four hundred and thirty‐four patients preoperatively diagnosed as EGC using EGD or S‐CT and undergoing curative gastrectomy at Seoul National University Hospital in 2005 were included. The T and N stage reviewed by experienced personnel were compared with the surgical pathology. Results The predictive values for EGC of EGD, S‐CT, and EUS were 87.4%, 92.2%, and 94.1%, respectively. The predictive values for node negativity of S‐CT, and EUS were 90.1% and 92.6%, respectively. The factors leading to underestimation of T stage with EGD were the upper third location, the size greater than 2 cm, and diffuse type of tumor. Those with S‐CT were female sex, the upper third location and lesion size greater than 2 cm. Conclusions Before applying limited treatment for EGC, a surgeon should consider the risk factors of underestimation of T stage with EGD or S‐CT. J. Surg. Oncol. 2009;99:20–27. © 2008 Wiley‐Liss, Inc.