Dr Simon Paterson-Brown and colleagues from England assessed current staging accuracies for individual modalities.
The researchers investigated the influence of the multidisciplinary team on clinical staging, and treatment selection with gastro-esophageal cancer.
The research team evaluated 118 newly diagnosed patients with gastric or esophageal cancer.
The patients studied were deemed suitable for surgical resection by the multidisciplinary team.
Patients were staged with a combination of computerized tomography, endoscopic ultrasound, and laparoscopic ultrasound.
|Staging by the multidisciplinary team results in under-treatment of only 2%|
|Diseases of the Esophagus|
Additionally, the multidisciplinary team determined an overall clinical stage for each patient after discussion at the multidisciplinary team meeting.
Treatments were selected according to this final clinical stage.
The researchers found that the final histopathological staging was available for all patients.
The research team used this as the gold standard for determining staging accuracy.
Suitability of treatment selection was assessed once final histopathological staging was available.
Endoscopic ultrasound was the most accurate individual staging modality for the loco-regional assessment of esophageal tumors.
Laparoscopic ultrasound was the most accurate modality in T staging of gastric cancers, with an accuracy of 91%.
The multidisciplinary team stage was more accurate than each individual staging modality for T and N staging for both gastric and esophageal cancers.
The team noted that the accuracy ranged from 88% to 89%, and was better for the assessment of nodal disease than each individual modality.
Dr Paterson-Brown's team concludes “Overall staging accuracy as determined at the multidisciplinary team meeting was increased and resulted in only 2% patients being under-treated.”
“The multidisciplinary team significantly improves staging accuracy for gastro-esophageal cancer.”
“It ensures that correct management decisions are made for the highest number of individual patients.”