Is endoscopic ultrasound a better choice for staging of gastric cancers?

Puli et al did a search to evaluate the accuracy of EUS in staging gastric cancers, and their results were published on 7 July 2008 in the World Journal of Gastroenterology.

Puli identified 1620 reference articles and 376 relevant articles were selected and reviewed. Twenty-two studies (N=1896) which met the inclusion criteria were included in this analysis. The meta-analysis shows that the pooled sensitivity of EUS for local tumour invasion (T stage) is high and it is higher for advanced disease when compared to early disease. The pooled specificity for depth of tumour invasion is very high for all the T stages. For determining lymph nodes involvement, all the pooled accuracy estimates of EUS are higher for advanced disease compared to early disease.

In the author's opinion, EUS is an accurate and minimally invasive diagnostic tool to evaluate local invasion (T stage) of a patient with gastric cancer. EUS results are more accurate with advanced disease than early disease. Considering that new curative and palliative endoscopic therapies are emerging as an alternative to surgery in gastric cancer, EUS should be strongly considered for staging. Their meta-analysis supports the use of EUS in determining if curative or palliative therapies are the most appropriate approach for a particular stage of the disease. Further studies are needed to improve accuracy of EUS in detecting early invasion of lymph nodes. This research did not have any financial support.