Hazem Hassan1, Peter Vilmann, Vijay Sharma. 1. Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Hellerup, Denmark.
Abstract
BACKGROUND: EUS is an integral part of the pretherapeutic evaluation program for patients with upper GI cancer. OBJECTIVE: To evaluate the impact of EUS-guided FNA on the clinical management of patients with gastric cancer. DESIGN: The study included patients with confirmed gastric carcinoma who were referred to the Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Copenhagen, Denmark, during a 6-year period (2001-2007). SETTING: The patients underwent standard pretherapeutic evaluation. If no signs of incurability were detected, the patients were offered EUS and EUS-guided FNA. EUS-guided FNA was performed when lymph nodes or lesions were considered to be distant metastases. A board of surgeons was asked to evaluate the management of the patients after the results obtained by EUS-guided FNA were revealed. PATIENTS: This study involved 234 patients with gastric carcinoma. INTERVENTION: EUS-guided FNA. MAIN OUTCOME MEASUREMENTS: Number of patients with distant metastasis diagnosed by EUS-guided FNA, with the avoidance of unnecessary surgery. RESULTS: A total of 81 consecutive patients underwent EUS-guided FNA. Ninety-nine lesions were targeted, and 61 (62%) of these lesions were found to be malignant. In 38 of 81 patients (42%) distant metastases were confirmed by EUS-guided FNA. As judged by the board of surgeons, EUS-guided FNA changed the management plan in 34 of 234 patients (15%). LIMITATION: The positive EUS-guided FNA diagnoses were not surgically verified. CONCLUSION: EUS-guided FNA is a very important modality and should be integrated as a routine procedure in the preoperative staging algorithm of gastric cancer. 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
BACKGROUND: EUS is an integral part of the pretherapeutic evaluation program for patients with upper GI cancer. OBJECTIVE: To evaluate the impact of EUS-guided FNA on the clinical management of patients with gastric cancer. DESIGN: The study included patients with confirmed gastric carcinoma who were referred to the Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Copenhagen, Denmark, during a 6-year period (2001-2007). SETTING: The patients underwent standard pretherapeutic evaluation. If no signs of incurability were detected, the patients were offered EUS and EUS-guided FNA. EUS-guided FNA was performed when lymph nodes or lesions were considered to be distant metastases. A board of surgeons was asked to evaluate the management of the patients after the results obtained by EUS-guided FNA were revealed. PATIENTS: This study involved 234 patients with gastric carcinoma. INTERVENTION: EUS-guided FNA. MAIN OUTCOME MEASUREMENTS: Number of patients with distant metastasis diagnosed by EUS-guided FNA, with the avoidance of unnecessary surgery. RESULTS: A total of 81 consecutive patients underwent EUS-guided FNA. Ninety-nine lesions were targeted, and 61 (62%) of these lesions were found to be malignant. In 38 of 81 patients (42%) distant metastases were confirmed by EUS-guided FNA. As judged by the board of surgeons, EUS-guided FNA changed the management plan in 34 of 234 patients (15%). LIMITATION: The positive EUS-guided FNA diagnoses were not surgically verified. CONCLUSION: EUS-guided FNA is a very important modality and should be integrated as a routine procedure in the preoperative staging algorithm of gastric cancer. 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Authors: Christian Jenssen; Jouke Tabe Annema; Paul Clementsen; Xin-Wu Cui; Mathias Maximilian Borst; Christoph Frank Dietrich Journal: J Thorac Dis Date: 2015-10 Impact factor: 2.895
Authors: Christoph F Dietrich; Christian Jenssen; Paolo G Arcidiacono; Xin-Wu Cui; Marc Giovannini; Michael Hocke; Julio Iglesias-Garcia; Adrian Saftoiu; Siyu Sun; Liliana Chiorean Journal: Endosc Ultrasound Date: 2015 Jul-Sep Impact factor: 5.628