caa a22 4500 475780485 CHVBK 20180406123643.0 cr unu---uuuuu 170329e20001001xx s 000 0 eng 10.1007/s004640010040 doi (NATIONALLICENCE)springer-10.1007/s004640010040 Endoscopic ultrasonography in the preoperative staging of gastric cancer [Elektronische Daten] Accuracy and impact on surgical therapy [S. Willis, S. Truong, S. Gribnitz, J. Fass, V. Schumpelick] Background: Endoscopic ultrasonography (EUS) is a standard procedure in the preoperative staging of patients with gastric carcinomas. Herein we present our experience with EUS and discuss the results and their implications for surgical therapy. Methods: A total of 116 patients with histologically confirmed gastric adenocarcinoma were referred to EUS and classified prospectively by the TNM system. The results of the preoperative endosonographic staging were compared with the definitive histopathological results after the operation. Results: The overall accuracy of EUS for determination of the T stage was 78%. The accuracy for the T1 and T2 stages was 80% and 63%, respectively. With 20% and 30%, there was a relatively high rate of overstaging in these cases. The accuracy for T3 and T4 tumors was 95% and 83%, respectively. The accuracy of EUS for determination of the N stage was 77%, with a sensitivity of 91% and a specificity of 84%. Resectability was predicted correctly with a sensitivity of 94% and a specificity of 83%. Conclusions: Generally accepted standards for the therapy of advanced gastric carcinomas do not exist. In cases where the therapeutic strategy is surgical exploration, no preoperative staging is necessary. In cases with differentiated treatment strategies, the accuracy of EUS is not sufficient for the selection of patients for endoscopic resection. Its accuracy for submucosal cancer invasion and for the detection of lymph node metastases needs to be further enhanced. If only multimodal therapy is considered, EUS staging seems to be absolutely mandatory. Patients classified preoperatively as T1 to T3 can be operated on primarily with sufficient security. In patients where radical resection of the tumor seems doubtful, we recommend that a diagnostic laparoscopy be performed to confirm the diagnosis. Springer-Verlag, 2000 Cancer nationallicence Endoscopic ultrasonography nationallicence Gastric carcinoma nationallicence Stomach nationallicence Willis S. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut Truong S. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut Gribnitz S. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut Fass J. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut Schumpelick V. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut Surgical Endoscopy Springer-Verlag 14/10(2000-10-01), 951-954 0930-2794 14:10<951 2000 14 464 https://doi.org/10.1007/s004640010040 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640010040 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Willis S. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut NATIONALLICENCE 700 1- Truong S. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut NATIONALLICENCE 700 1- Gribnitz S. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut NATIONALLICENCE 700 1- Fass J. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut NATIONALLICENCE 700 1- Schumpelick V. Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52057, Aachen, Germany aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/10(2000-10-01), 951-954 0930-2794 14:10<951 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer