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Comparative Study
. 2010 Dec;8(12):1037-41.
doi: 10.1016/j.cgh.2010.08.020. Epub 2010 Sep 8.

Endoscopic ultrasound does not accurately stage early adenocarcinoma or high-grade dysplasia of the esophagus

Patrick E Young  1 , Andrew B Gentry, Ruben D Acosta, Bruce D Greenwald, Mark Riddle
Affiliations
Comparative Study

Endoscopic ultrasound does not accurately stage early adenocarcinoma or high-grade dysplasia of the esophagus

Patrick E Young et al. Clin Gastroenterol Hepatol. 2010 Dec.

Abstract

Background & aims: Patients with esophageal high-grade dysplasia or mucosal esophageal cancer can be successfully treated by 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 to 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 EMR/surgical staging.

Conclusions: EUS 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.

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