Factors associated with the efficacy of miniprobe endoscopic ultrasonography after conventional endoscopy for the prediction of invasion depth of early gastric cancer

Abstract

Background: This study aimed to compare the accuracy of conventional endoscopy (CE) and endoscopic ultrasonography (EUS) to predict tumor invasion depth and to determine factors associated with higher accuracy of additional miniprobe EUS after CE.

Methods: Between May 2009 and February 2015, 273 lesions in 266 patients were subjected to miniprobe EUS after CE and curative treatment for well-to-moderately differentiated early gastric cancer (EGC). We reviewed preoperative CE and EUS findings and compared them to the pathologic findings.

Results: The accuracy of CE and EUS to estimate the invasion depth of EGCs was 78.8% (215/273) and 83.9% (229/273) (p = .124), respectively. Using multivariate analysis, irregular depressed surface (odds ratio [OR] 8.11; 95% confidence interval [CI]: 2.79-23.53), fold change (OR 7.22; 95% CI: 2.33-22.38), size >2 cm (OR 2.72; 95% CI: 1.15-6.42) and ulcer scar (OR 2.64; 95% CI: 1.07-6.49) were associated with the higher accuracy of EUS than that of CE.

Conclusions: Routine assessment using miniprobe EUS did not increase the accuracy of predicting invasion depth, compared to CE. However, EUS could be helpful in the treatment decision-making process for EGCs with lesions having irregular surfaces, fold change, size >2 cm, or ulcer scar.

Keywords: Gastric cancer; endoscopic gastrointestinal surgery; endoscopic ultrasonography; endoscopy; staging.