Role of endoscopic ultrasonography in gastric carcinoma.

Two hundred and fifty four consecutive patients with gastric adenocarcinoma who underwent surgery were preoperatively evaluated with endoscopic ultrasonography (EUS). The results were compared with the post-operative histo-pathological staging. EUS was correct in determining the T and N stage in 83% and 66%, respectively. Although EUS was accurate in determining the absence of lymph node metastases (accuracy in stage N0: 93%), it was not reliable in determining stages N1 and N2 (64% and 52%, respectively). Since 88% of all T3 and T4 tumors had lymph node metastases, the concomitant T stage may be an important criterion for assessing the nature of endosonographically visualized lymph nodes. The actual R0-resection rate (78%) was almost identical to the rate predicted preoperatively by EUS (81%). We therefore consider EUS a valuable pretherapeutic procedure in patients with gastric carcinoma.