A specific role of endoscopic ultrasonography for therapeutic decision-making in patients with gastric cardia cancer

Chan Hyuk Park, Jun Chul Park, Hyunsoo Chung, Sung Kwan Shin, SangKil Lee, Yongchan Lee

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)4193-4199
Number of pages7
JournalSurgical endoscopy
Volume30
Issue number10
DOIs
Publication statusPublished - 2016 Oct 1

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Endosonography
Cardia
Stomach Neoplasms
Decision Making
Neoplasms
Heart Neoplasms
Confidence Intervals
Therapeutics
Mucous Membrane
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Park, Chan Hyuk ; Park, Jun Chul ; Chung, Hyunsoo ; Shin, Sung Kwan ; Lee, SangKil ; Lee, Yongchan. / A specific role of endoscopic ultrasonography for therapeutic decision-making in patients with gastric cardia cancer. In: Surgical endoscopy. 2016 ; Vol. 30, No. 10. pp. 4193-4199.
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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-na{\"i}ve 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.",
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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, SangKil; Lee, Yongchan.

In: Surgical endoscopy, Vol. 30, No. 10, 01.10.2016, p. 4193-4199.

Research output: Contribution to journalArticle

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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.

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