Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 21 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Staging of tumors of the esophagus and gastric cardia

Researchers from Germany find that endosonography is the most accurate modality for preoperative staging of esophageal and cardial tumors.

News image

fiogf49gjkf04

Therapeutic strategies for tumors of the esophagus and gastric cardia require precise preoperative staging.

Endosonography is considered the most accurate staging method. Computed tomography (CT) has limitations, especially in the evaluation of local infiltration.

Macroscopic endoscopic evaluation has also been reported to be accurate, but no study has compared all 3 of these modalities.

The research team prospectively staged 117 unselected patients with tumors of the esophagus and gastric cardia. Patients were first assessed by the endoscopic macroscopic appearance and then by endosonography. In addition, all patients had preoperative CT scans.

Only the 36 patients receiving the scans at the team's own institution were included in this study.

Accuracy of predicting lymph node metastasis was greatest using endosonographic staging.
Digestion

The research team's findings are reported in the latest issue of Digestion.

The researchers compared preoperative staging results to postoperative histology. This was available as the gold standard in all included patients.

They used Kappa statistics to exclude the chance agreement of clinical staging results with the pathohistological findings.

The differences between the values for the different staging modalities were analyzed using a jack-knife test.

The research team found that endoscopic macroscopic staging and endosonography were significantly more accurate than CT for determination of the T category. Results were 67%, 69% and 33%, respectively.

After the team excluded tumors of the cardia, the accuracy of macroscopic and endosonographic staging increased. These modalities remained more accurate than CT; 72%, 75% and 50%, respectively.

However, when staging of the T category, the team found that T2 tumors in the cardia were overestimated as T3 or even as T4 tumors, due to the inability to visualize the serosa.

The team determined that the accuracy of predicting lymph node metastasis was 68% for macroscopic endoscopic, 79% for endosonographic, and 67% for CT staging.

They determined that only endosonographic staging was significantly different from a chance agreement with the histology.

Dr Peter Kienleb's team concluded, "Endosonography is the most accurate staging modality for overall preoperative staging of esophageal and cardial tumors".

"Endoscopic macroscopic staging allows a reasonably accurate assessment of the T category."

Digestion 2003; 66(4): 230-6
25 February 2003

Go to top of page Email this page Email this page to a colleague

 19 January 2018 
Ileoanal pouch microbiota
 19 January 2018 
Predicting the risk of early surgery in Crohn’s
 19 January 2018 
Lifestyle intervention vs gastric bypass for obesity and diabetes
 18 January 2018 
Sleeve gastrectomy vs Roux-en-Y gastric bypass
 18 January 2018 
Healthcare costs of liver cancer in the USA
 18 January 2018 
High-risk adenomas at colonoscopy
 17 January 2018 
“Weekend effect” in upper GI hemorrhage
 17 January 2018 
Gut dysbiosis and non-antibiotic prescription medications
 17 January 2018 
Reducing surgical infections in high-outlier colorectal unit
 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Yoga vs low-FODMAP in IBS
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Management of abnormal liver blood tests
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Early readmission in IBD patients
 18 December 2017 
Colorectal cancer mortality with low-risk adenomas at colonoscopy
 18 December 2017 
Disease activity indices in celiac disease
 18 December 2017 
Smoking behaviour predicted the risk of surgery in Crohn's
 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk
 14 December 2017 
PPIs and gastric cancer after H.pylori eradication
 14 December 2017 
H. pylori eradication therapies in countries with clarithromycin resistance
 13 December 2017 
Disease severity in NAFLD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us