Correlation between preoperative endoscopic ultrasound and surgical pathology staging of gastric adenocarcinoma: A single institution retrospective review

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Abstract
Background: Recent evidence validates the effectiveness of neoadjuvant chemotherapy in the treatment of gastric adenocarcinoma. Endoscopic ultrasonographic (EUS) staging has been proposed as a useful adjunct in this setting.Methods: We performed a retrospective review of patients treated at our institution for gastric adenocarcinoma between July 2005 and January 2014. We identified patients referred for EUS before surgery as part of a prospective treatment plan. Histopathologic staging was compared to EUS staging, with a focus on T‐ and N‐stage. Agreement between the two modalities was examined using kappa‐statistics.Results: We identified 614 patients with biopsy‐proven gastric adenocarcinoma; 145 underwent curative‐intent surgery. Surgical pathology and EUS results were available from 69 patients. The accuracy of EUS for the evaluation of T‐ and N‐stage was 44.9% and 56.5%, respectively. EUS demonstrated greater concordance with histopathology at evaluating T‐stage (κ = 0.3469) than N‐stage (κ = 0.1316). EUS underestimated T‐ and N‐stage in 40.8% and 30.4% of patients, respectively.Conclusion: EUS seems to correlate poorly with pathology in the preoperative staging of gastric adenocarcinoma. In the majority of inaccurate cases, EUS underestimates T‐stage and N‐stage, limiting its utility in the neoadjuvant setting. J. Surg. Oncol. 2016;113:42–45.

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