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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

Open Access 01-12-2016 | Thoracic Oncology

Value of EUS in Determining Curative Resectability in Reference to CT and FDG-PET: The Optimal Sequence in Preoperative Staging of Esophageal Cancer?

Authors: L. M. A. Schreurs, MD, A. C. J. W. Janssens, PhD, H. Groen, MD, PhD, P. Fockens, MD, PhD, H. M. van Dullemen, MD, PhD, M. I. van Berge Henegouwen, MD, PhD, G. W. Sloof, MD, PhD, J. Pruim, MD, PhD, J. J. B. van Lanschot, MD, PhD, E. W. Steyerberg, PhD, J. Th. M. Plukker, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 5/2016

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Abstract

Background

The separate value of endoscopic ultrasonography (EUS), multidetector computed tomography (CT), and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the optimal sequence in staging esophageal cancer has not been investigated adequately.

Methods

The staging records of 216 consecutive operable patients with esophageal cancer were reviewed blindly. Different staging strategies were analyzed, and the likelihood ratio (LR) of each module was calculated conditionally on individual patient characteristics. A logistic regression approach was used to determine the most favorable staging strategy.

Results

Initial EUS results were not significantly related to the LRs of initial CT and FDG-PET results. The positive LR (LR+) of EUS-fine-needle aspiration (FNA) was 4, irrespective of CT and FDG-PET outcomes. The LR+ of FDG-PET varied from 13 (negative CT) to 6 (positive CT). The LR+ of CT ranged from 3–4 (negative FDG-PET) to 2–3 (positive FDG-PET). Age, histology, and tumor length had no significant impact on the LRs of the three diagnostic tests.

Conclusions

This study argues in favor of PET/CT rather than EUS as a predictor of curative resectability in esophageal cancer. EUS does not correspond with either CT or FDG-PET. LRs of FDG-PET were substantially different between subgroups of negative and positive CT results and vice versa.
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Metadata
Title
Value of EUS in Determining Curative Resectability in Reference to CT and FDG-PET: The Optimal Sequence in Preoperative Staging of Esophageal Cancer?
Authors
L. M. A. Schreurs, MD
A. C. J. W. Janssens, PhD
H. Groen, MD, PhD
P. Fockens, MD, PhD
H. M. van Dullemen, MD, PhD
M. I. van Berge Henegouwen, MD, PhD
G. W. Sloof, MD, PhD
J. Pruim, MD, PhD
J. J. B. van Lanschot, MD, PhD
E. W. Steyerberg, PhD
J. Th. M. Plukker, MD, PhD
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1738-8

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