Endoscopic Ultrasound (EUS) in Gastric Cancer: Current Applications and Future Perspectives

Area of Science:

• Gastroenterology
• Oncology
• Medical Imaging

Background:

• Gastric cancer is a leading cause of mortality, with prognosis heavily influenced by early diagnosis and accurate staging.
• Locoregional staging (T and N) is vital for effective gastric cancer management and therapeutic planning.
• Endoscopic ultrasound (EUS) is a key imaging modality for gastric cancer assessment.

Purpose of the Study:

• To review and analyze the multifaceted role of Endoscopic Ultrasound (EUS) in managing gastric cancer.
• To highlight EUS applications across various disease stages, from early detection to advanced unresectable disease.
• To compare EUS performance against other imaging modalities like CT and PET-CT.

Main Methods:

• Review of current literature on Endoscopic Ultrasound (EUS) in gastric cancer diagnosis and staging.
• Analysis of EUS utility in early gastric cancer, restaging after neoadjuvant chemotherapy, and managing complications.
• Evaluation of emerging EUS techniques (contrast-enhancement, elastography, AI) and EUS-guided interventions (EUS-GE).

Main Results:

• EUS is essential for assessing early gastric cancer, facilitating endoscopic resection and improved quality of life.
• EUS aids in restaging post-neoadjuvant chemotherapy, guiding resectability and prognostic evaluation.
• EUS-guided gastroenterostomy (EUS-GE) provides a less invasive option for gastric outlet obstruction palliation.

Conclusions:

• Endoscopic Ultrasound (EUS) plays a critical and evolving role throughout the gastric cancer care continuum.
• EUS performance in staging and management can be enhanced by novel techniques and artificial intelligence.
• EUS offers valuable diagnostic and therapeutic options, improving patient management and quality of life in gastric cancer.