Endoscopic Ultrasound Does Not Accurately Stage Early Adenocarcinoma or High-Grade Dysplasia of the Esophagus
NAVAL MEDICAL RESEARCH CENTER SILVER SPRING MD
Pagination or Media Count:
Patients with esophageal high grade dysplasia or mucosal esophageal cancer can he successfully treated hy endoscopy. We performed a systematic review of the literature to determine whether endoscopic ultrasound EUS correctly predicts the T-stage of early esophageal cancers, compared with pathology specimens obtained by using endoscopic mucosal resection EMR or surgery. METHODS Standard systematic review methods were used w perform reference searches, determine eligibility, abstract data, and analyze data. When possible, individual patient-level data were abstracted, in addition to publication- level aggregate data. RESULTS Twelve studies had sufficient information to abstract and review for quality 8 had individual patient-level data n 132. Compared with surgical or EMR pathology staging, EUS had T-stage concordance of 65, including all studies n 12, but only 56 concordance when limited to individual patient-level data. Factors such as initial biopsy pathology high-grade dysplasia vs early-stage cancer did not appear to affect the concordance of staging between EUS and EMRsurgical staging. CONCLUSIONS BUS is not sufficiently accurate in determining the T -stage of high-grade dysplasias or superficial adenocarcinomas other means of staging, such as EMR, should be used.
- Medicine and Medical Research