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• W2087991677 abstract "Background/Aim: Previous studies about the accuracy rate of EUS of EGC have used the specimen of operation which allows evaluating full thickness of tumor depth. A relevant question has been raised whether endoscopic submucosal dissection (ESD) specimen allows evaluating tumor depth invasion in the dissected specimen whereas EMR specimen is not optimally possible in the aspect of clinical effectiveness with a proper staging by EUS. We retrospectively compared the outcome after pathologic reports of how EUS effectively determined the invasion depth in the ESD group with the outcome of the surgery group. Patients and methods: We retrospectively reviewed 351 EGC patients who underwent ESD and 114 patients surgically treated from October 2003 to June 2006. All patients had EUS performed before either of the therapeutic interventions. Retrospective EUS reviews were classified as three patterns according to its clinical correlation to make a proper staging work-up of EGC. Pathologic depth was the mainstay to make a clear classification of the three EUS patterns as clinical congruity, underestimation (deeper invasion than EUS), and overestimation (deeper prediction than pathology). Further, the diagnostic accuracy of EUS in lymph node (LN) staging was also tried in both groups. Results: The overall accuracy rate of EUS in both groups was 81.3% (377/464); 84.4% (296/351) in the ESD group and 71.7% (81/113) in the surgery group. Those underestimation and overestimation rates were 7.1% and 8.5% in the ESD group, 4.4% and 23.9% in the surgery group, respectively. The ESD group had more underestimation rate. Location wise, gastric body was the most underestimated and the lesions without ulcer or less than 2 cm in size were also underestimated in the ESD group (P < 0.05). None of patients in the ESD group had any LN enlargement in pre-ESD EUS. Evidently, even those who underwent a following operation because of incomplete resection did not show any LN metastasis. Lymph node enlargement had been observed in 10 cases before surgery and five of them were confirmed as LN metastasis after operation (positive predictive valve 50%). In the surgery group, total 7 cases manifested LN metastasis after surgical operations, as mentioned above, 5 cases were observed with node enlargement preoperatively in EUS (sensitivity 71.4%). Conclusion: Like the surgery group, EUS appears to be useful to improve diagnostic accuracy for the ESD group in assessing the depth of invasion and LN staging." @default.
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• W2087991677 date "2008-04-01" @default.
• W2087991677 modified "2023-10-18" @default.
• W2087991677 title "EUS in the Evaluation of the Patients Performed Endoscopic Submucosal Dissection" @default.
• W2087991677 doi "https://doi.org/10.1016/j.gie.2008.03.515" @default.
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