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[Echo endoscopy in the local staging of gastric cancer]
L C Ribeiro1, L Tavares, A Marques
1Unidade de Técnicas de Gastrenterologia, Hospital de Santa Maria, Lisboa.
Objectives:
to evaluate the accuracy of endoscopic ultrasonography (EUS) in the pre-operative T and N staging of gastric cancer.
Patients And Methods:
41 consecutive patients with gastric cancer (35 carcinomas and 6 lymphomas) underwent EUS using an Olympus GF-UM20, with 360 degrees sector scan and interchangeable frequency (7.5-12 MHz). They were classified as T1-T4 and N0-N2, according to the TNM system. These results were then compared with the surgical and pathological staging (SP), by the weighted K statistic (Kw).
Results:
In 2 patients EUS staging was not possible due to cardiac stenosis and in other 4 patients, information about SP staging was not available. In the remaining 35 patients the EUS/SP agreement was good (Kw = 0.80) for stage T and moderate (Kw = 0.49) for stage N. Non-agreement was mostly due to EUS understaging, both T and N.
Conclusions:
1) EUS is the most accurate procedure for pre-operative local staging of gastric cancer, and 2) EUS should preferably be performed by endoscopists with sonographic experience and a particular interest in the method.