Accession Number : ADA551701


Title :   Endoscopic Ultrasound Does Not Accurately Stage Early Adenocarcinoma or High-Grade Dysplasia of the Esophagus


Descriptive Note : Journal article


Corporate Author : NAVAL MEDICAL RESEARCH CENTER SILVER SPRING MD


Personal Author(s) : Young, Patrick E ; Gentry, Andrew B ; Acosta, Ruben D ; Greenwald, Bruce D ; Riddle, Mark


Full Text : http://www.dtic.mil/get-tr-doc/pdf?AD=ADA551701


Report Date : Jan 2010


Pagination or Media Count : 6


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.


Descriptors :   *CANCER , *DYSPLASIA , *ESOPHAGUS , AGGREGATES(MATERIALS) , MUCOUS MEMBRANES , PATHOLOGY , PATIENTS , STAGING


Subject Categories : Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE