Value of EUS in Determining Curative Resectability in Reference to CT and FDG-PET: The Optimal Sequence in Preoperative Staging of Esophageal CancerReport as inadecuate




Value of EUS in Determining Curative Resectability in Reference to CT and FDG-PET: The Optimal Sequence in Preoperative Staging of Esophageal Cancer - Download this document for free, or read online. Document in PDF available to download.

Annals of Surgical Oncology

, Volume 23, Supplement 5, pp 1021–1028

First Online: 06 May 2011Received: 08 October 2010DOI: 10.1245-s10434-011-1738-8

Cite this article as: Schreurs, L.M.A., Janssens, A.C.J.W., Groen, H. et al. Ann Surg Oncol 2016 23Suppl 5: 1021. doi:10.1245-s10434-011-1738-8

Abstract

BackgroundThe separate value of endoscopic ultrasonography EUS, multidetector computed tomography CT, and F-fluorodeoxyglucose positron emission tomography FDG-PET in the optimal sequence in staging esophageal cancer has not been investigated adequately.

MethodsThe staging records of 216 consecutive operable patients with esophageal cancer were reviewed blindly. Different staging strategies were analyzed, and the likelihood ratio LR of each module was calculated conditionally on individual patient characteristics. A logistic regression approach was used to determine the most favorable staging strategy.

ResultsInitial EUS results were not significantly related to the LRs of initial CT and FDG-PET results. The positive LR LR+ of EUS-fine-needle aspiration FNA was 4, irrespective of CT and FDG-PET outcomes. The LR+ of FDG-PET varied from 13 negative CT to 6 positive CT. The LR+ of CT ranged from 3–4 negative FDG-PET to 2–3 positive FDG-PET. Age, histology, and tumor length had no significant impact on the LRs of the three diagnostic tests.

ConclusionsThis study argues in favor of PET-CT rather than EUS as a predictor of curative resectability in esophageal cancer. EUS does not correspond with either CT or FDG-PET. LRs of FDG-PET were substantially different between subgroups of negative and positive CT results and vice versa.

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Author: L. M. A. Schreurs - A. C. J. W. Janssens - H. Groen - P. Fockens - H. M. van Dullemen - M. I. van Berge Henegouwen

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