Abstract
Background: The role of endoscopic ultrasonography (EUS) in gastric cardia cancer should be further evaluated because the accuracy of EUS depends on tumor location. We aimed to identify a specific role of EUS for therapeutic decision-making in patients with gastric cardia cancer. Methods: Initial EUS examinations for treatment-naïve gastric cancer that were followed by endoscopic resection or surgery were included in the study. Lesions were classified as cardiac and non-cardiac cancer according to tumor location. The diagnostic performance of EUS in predicting invasion depth was compared between the two groups. Results: The overall accuracy of EUS in predicting invasion depth did not differ between the cardiac and non-cardiac cancer groups (44.4 vs. 52.3 %, P = 0.259). The underestimation rate was higher in the cardiac cancer group than in the non-cardiac cancer group (37.0 vs. 18.5 %, P = 0.001). When the depth of invasion was predicted to be deeper than the mucosa (submucosal or deeper) by EUS, the positive predictive value was 82.1 [95 % confidence interval (CI), 66.5–92.5 %] and 62.9 % (95 % CI, 60.5–66.9 %) in the cardiac and non-cardiac cancer groups, respectively (P = 0.015). In multivariable analysis, tumor location in the cardia was found to be an independent factor for the underestimation of invasion depth [odds ratio (95 % CI) = 2.242 (1.156–4.349)]. Conclusions: The underestimation rate in predicting invasion depth was significantly higher for cardiac cancers than for non-cardiac cancers. Therefore, selection of the treatment method for gastric cardia cancer via EUS should be done carefully.
| Original language | English |
|---|---|
| Pages (from-to) | 4193-4199 |
| Number of pages | 7 |
| Journal | Surgical endoscopy |
| Volume | 30 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2016 Oct 1 |
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All Science Journal Classification (ASJC) codes
- Surgery
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A specific role of endoscopic ultrasonography for therapeutic decision-making in patients with gastric cardia cancer. / Park, Chan Hyuk; Park, Jun Chul; Chung, Hyunsoo; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan.
In: Surgical endoscopy, Vol. 30, No. 10, 01.10.2016, p. 4193-4199.Research output: Contribution to journal › Article
TY - JOUR
T1 - A specific role of endoscopic ultrasonography for therapeutic decision-making in patients with gastric cardia cancer
AU - Park, Chan Hyuk
AU - Park, Jun Chul
AU - Chung, Hyunsoo
AU - Shin, Sung Kwan
AU - Lee, Sang Kil
AU - Lee, Yong Chan
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background: The role of endoscopic ultrasonography (EUS) in gastric cardia cancer should be further evaluated because the accuracy of EUS depends on tumor location. We aimed to identify a specific role of EUS for therapeutic decision-making in patients with gastric cardia cancer. Methods: Initial EUS examinations for treatment-naïve gastric cancer that were followed by endoscopic resection or surgery were included in the study. Lesions were classified as cardiac and non-cardiac cancer according to tumor location. The diagnostic performance of EUS in predicting invasion depth was compared between the two groups. Results: The overall accuracy of EUS in predicting invasion depth did not differ between the cardiac and non-cardiac cancer groups (44.4 vs. 52.3 %, P = 0.259). The underestimation rate was higher in the cardiac cancer group than in the non-cardiac cancer group (37.0 vs. 18.5 %, P = 0.001). When the depth of invasion was predicted to be deeper than the mucosa (submucosal or deeper) by EUS, the positive predictive value was 82.1 [95 % confidence interval (CI), 66.5–92.5 %] and 62.9 % (95 % CI, 60.5–66.9 %) in the cardiac and non-cardiac cancer groups, respectively (P = 0.015). In multivariable analysis, tumor location in the cardia was found to be an independent factor for the underestimation of invasion depth [odds ratio (95 % CI) = 2.242 (1.156–4.349)]. Conclusions: The underestimation rate in predicting invasion depth was significantly higher for cardiac cancers than for non-cardiac cancers. Therefore, selection of the treatment method for gastric cardia cancer via EUS should be done carefully.
AB - Background: The role of endoscopic ultrasonography (EUS) in gastric cardia cancer should be further evaluated because the accuracy of EUS depends on tumor location. We aimed to identify a specific role of EUS for therapeutic decision-making in patients with gastric cardia cancer. Methods: Initial EUS examinations for treatment-naïve gastric cancer that were followed by endoscopic resection or surgery were included in the study. Lesions were classified as cardiac and non-cardiac cancer according to tumor location. The diagnostic performance of EUS in predicting invasion depth was compared between the two groups. Results: The overall accuracy of EUS in predicting invasion depth did not differ between the cardiac and non-cardiac cancer groups (44.4 vs. 52.3 %, P = 0.259). The underestimation rate was higher in the cardiac cancer group than in the non-cardiac cancer group (37.0 vs. 18.5 %, P = 0.001). When the depth of invasion was predicted to be deeper than the mucosa (submucosal or deeper) by EUS, the positive predictive value was 82.1 [95 % confidence interval (CI), 66.5–92.5 %] and 62.9 % (95 % CI, 60.5–66.9 %) in the cardiac and non-cardiac cancer groups, respectively (P = 0.015). In multivariable analysis, tumor location in the cardia was found to be an independent factor for the underestimation of invasion depth [odds ratio (95 % CI) = 2.242 (1.156–4.349)]. Conclusions: The underestimation rate in predicting invasion depth was significantly higher for cardiac cancers than for non-cardiac cancers. Therefore, selection of the treatment method for gastric cardia cancer via EUS should be done carefully.
UR - http://www.scopus.com/inward/record.url?scp=84951933310&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84951933310&partnerID=8YFLogxK
U2 - 10.1007/s00464-015-4728-2
DO - 10.1007/s00464-015-4728-2
M3 - Article
C2 - 26715019
AN - SCOPUS:84951933310
VL - 30
SP - 4193
EP - 4199
JO - Surgical Endoscopy
JF - Surgical Endoscopy
SN - 0930-2794
IS - 10
ER -