Capacity of Endoscopic Ultrasound in the Preoperative Staging of Gastric Cancer
Objectives: To assess prospects of endoscopic ultrasonography in the diagnostic methods of gastric cancer in our study and to determine the impact of this technique on the later use of therapy. Material and methods: This is a retrospective study which was conducted on the patients with histopathologic diagnosis of gastric adenocarcinoma being sent to examination with endoscopic ultrasound. We compared the initial decision concerning the therapy being based on the conventional diagnostic techniques with the application of the final therapy, which is based on the results of endoscopic ultrasound. Results: The study included 92 patients in the period from 2005 to 2010. The diagnostic precision was 71% in stage T, while in stages T1, T2, T3 and T4 the diagnostic precision was 100, 42, 78, and 100%. The sensitivity and accuracy for differentiation of T1-2 from T3- 4 was 95 and 82%. We could not identify factors associated with obtaining a correct diagnosis in staging T. The diagnostic accuracy was 74% for N stage (N0: 55% Nx 81%). The presence of the free perigastric fluid was found in 5 cases while the presence of peritoneal carcinomatosis was subsequently confirmed in 2 cases. The result of endoscopic US has led to some changes in subsequent therapeutic management in 26 patients (28%). Conclusion: Endoscopic ultrasonography is a useful technique for loco-regional staging in gastric adenocarcinoma, which can have significant implications for the therapeutic treatment of these patients.