In this study, doctors from the Netherlands examined whether the number of EUS investigations performed in a center affects the results of esophageal cancer staging.
The team compared T staging in a low-volume EUS center with reported results from 7 high-volume EUS centers.
Between 1994 and 2003, 244 patients underwent EUS; 670 EUS investigations for esophageal cancer were performed.
The main outcome measures were sensitivity and specificity of EUS for esophageal cancer staging.
The doctors found that the results of EUS for T3 staging had comparable sensitivity between the low and high volume centers (85% vs 88%-94%). Specificity was lower in the low volume center (57% vs 75%-90%).
For T1 and T2 stages, both sensitivity (58% vs 75%-90%) and specificity (87% vs 94%-97%) were lower in the low-volume center.
|Specificity was lower in the low volume center.|
Furthermore, sensitivities of EUS for regional (45% vs 63%-89%) and celiac (19% vs 72%-83%) lymph nodes were lower in the low-volume center.
Results in the low-volume EUS center were poorer if the EUS probe could not pass the stricture; this occurred in almost 30% of patients.
Dr Evelyn van Vliet's team concluded, "The results of EUS performed in a low-volume EUS center compared unfavorably with those reported from high-volume EUS centers".
"The results of this study suggest that preoperative staging by EUS should be performed by experienced and dedicated EUS endoscopists to optimize staging of esophageal cancer".