Low accuracy of endoscopic ultrasonography for detailed T staging in gastric cancer
1 Department of Surgery, Division of Gastrointestinal Surgery, College of Medicine, The Catholic University of Korea, Seoul, South Korea
2 Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea
World Journal of Surgical Oncology 2012, 10:190 doi:10.1186/1477-7819-10-190Published: 15 September 2012
The accuracy of endoscopic ultrasonography (EUS) for preoperative staging of gastric cancer varies. The aim of this study was to investigate the accuracy of EUS tumor (T) and node (N) staging, and to identify the histopathological factors influencing accuracy based on the detailed tumor depth of gastric cancer.
In total, 309 patients with gastric cancer with confirmed pathological staging underwent EUS examination for preoperative staging at Seoul St. Mary’s Hospital, Korea, between January and December 2009. The T and N staging of EUS and the pathologic report were compared.
The overall accuracies of EUS for T stage and the detailed T stages were 70.2% and 43.0%, respectively. In detailed stage, tumors greater than 50 mm in diameter were significantly associated with T overstaging (odds ratio (OR) = 2.094). The overall accuracy of EUS for N staging was 71.2%. Tumor size (20 mm ≤ size < 50 mm, OR = 4.389; and 50 mm ≤ size, OR = 8.170), cross-sectional tumor location (circumferential, OR = 4.381) and tumor depth (submucosa, OR = 3.324; muscular propria, OR = 6.923; sub-serosa, OR = 4.517; and serosa-exposed, OR = 6.495) were significant factors affecting incorrect nodal detection.
Careful attention is required during EUS examination of large-sized gastric cancers to increase accuracy, especially for T staging.