Linear EUS Accuracy in Preoperative Staging of Gastric Cancer: A Retrospective Multicenter Study

Introduction: Preoperative gastric cancer (GC) staging is the most reliable prognostic factor that affects therapeutic strategies. Contrast-enhanced computed tomography (CECT) and radial endoscopic ultrasound (R-EUS) scans are the most commonly used staging tools for GC. The accuracy of linear EUS (L-EUS) in this setting is still controversial. The aim of this retrospective multicenter study was to evaluate the accuracy of L-EUS and CECT in preoperative GC staging, with regards to depth of tumor invasion (T staging) and nodal involvement (N staging). Materials and methods: 191 consecutive patients who underwent surgical resection for GC were retrospectively enrolled. Preoperative staging had been performed using both L-EUS and CECT, and the results were compared to postoperative staging by histopathologic analysis of surgical specimens. Results: L-EUS diagnostic accuracy for depth of invasion of the GC was 100%, 60%, 74%, and 80% for T1, T2, T3, and T4, respectively. CECT accuracy for T staging was 78%, 55%, 45%, and 10% for T1, T2, T3, and T4, respectively. L-EUS diagnostic accuracy for N staging of GC was 85%, significantly higher than CECT accuracy (61%). Conclusions: Our data suggest that L-EUS has a higher accuracy than CECT in preoperative T and N staging of GC.

Automated summary

This retrospective multicenter study aimed to evaluate the accuracy of linear endoscopic ultrasound (L-EUS) and contrast-enhanced computed tomography (CECT) in preoperative gastric cancer (GC) staging. The results showed that L-EUS had a higher diagnostic accuracy than CECT for depth of invasion (T staging) and nodal involvement (N staging) of GC. L-EUS had an accuracy of 100%, 60%, 74%, and 80% for T1, T2, T3, and T4, respectively, while CECT had an accuracy of 78%, 55%, 45%, and 10%. L-EUS also had a higher accuracy for N staging (85%) compared to CECT (61%).