Role of Endoscopic Ultrasonography (EUS) Versus Computerised Tomography (CT) Scan in Staging of Gastric Malignancy

Ahmed Hammad, Mr, Mohamed Shams, Mr, Mohamed Gamil, PhD, Reda Tabash, PhD, Ali Amin, Mr. National Cancer Institute, Cairo University, Cairo, Egypt

 

Objective of the study:
Evaluation of the practical application of EUS compared to CT scan in staging of gastric malignancy.
Methods and procedures:
Patients diagnosed or clinically suspected to have gastric tumour were subjected to upper gastrointestinal scope and EUS at the same time.
Forty patients were involved in the study over two year period.

Number of patients(n) Pathological diagnosis
27 Adenocarcinoma
10 Gastric lymphoma
2 Left lobe hepatocellular carcinoma, pancreatic head tumour invading the stomach
1 Benign peptic ulcer

Last three cases were excluded from the study as the diagnosis was not primary gastric malignancy  and five patients were excluded as they did not undergo operation and no operative pathology obtained.
All patients had staging CT chest abdomen and pelvis (cap).
Results:
Tumour staging (T) by EUS and CT scan compared with operative pathology:
 

Operative pathology stage n EUS Tx EUS T1 EUS T2 EUS T3 EUS T4 CT Tx CT T1/2 CT T3 CT T4
T1 1   1         1    
T2 4     4       3 1  
T3 15     1 12 2   2 8 5
T4 12         12     5 7
T with no operative pathology 5   1   2 2 1   4  
Total 37   2 5 14 16 1 6 18 12

Total accuracy of EUS staging was 29 out of 32 lesions 91% with one lesion under staged 6% and two lesions over staged 13%, the 95% confidence interval (C.I) was (79%-100%) with p value (p=0.0005)
The total accuracy of CT was 19 out of 32 lesions 60% with seven lesion under staged 22% and six lesions over staged 18%, the 95% confidence interval (C.I) was (24%-76%) with p value (p=0.38)

Conclusion:

EUS is a non invasive safe and superior to CT scan in T staining of gastric malignancy and should be one of the pre-therapeutic methods in staging before considering different treatment modalities.
 


Session Number: Poster – Poster Presentations
Program Number: P223
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