Endoscopic ultrasonography in cancer staging for gastrointestinal malignancies

Year 2010, Volume: 18 Issue: 3, 74 - 80, 01.12.2010

Mehmet Bektaş Manoop S Bhutanı

https://doi.org/10.17940/endoskopi.74891

Abstract

Endoscopic ultrasonography has gained a pivotal role in cancer staging for gastrointestinal malignancies because of its ability to image both the layers of the intestinal wall and peri-intestinal lymph nodes and organs. Endoscopic ultrasonography should be used after computerized tomography, positron emission tomography scanning or magnetic resonance imaging scan has shown no distant metastatic disease. The TNM classification is used for gastrointestinal system cancer staging with endoscopic ultrasonography. Endoscopic ultrasonography staging accuracy is applicable to all luminal gastrointestinal tract cancers, with an approximate T-stage accuracy of 85% and N-stage accuracy of 75%. Accurate cancer staging is needed because it provides prognostic information and guides treatment. Additionally, endoscopic ultrasonography fine-needle aspiration can be used to biopsy any malignantappearing lymph nodes, and it slightly increases the N-stage accuracy.

Keywords

Endoscopic ultrasonography, cancer staging, gastrointestinal system cancer

Gastrointestinal sistem kanserlerinin evrelemesinde endoskopik ultrasonografi

Abstract

Endoskopik ultrosonografi, barsak duvarının tüm katmanlarının ve barsak çevresi lenf nodlarını gösterebilmesi nedeniyle gastrointestinal sistem kanserlerinin evrelemesinde kilit rol oynar. Endoskopik ultrosonografi ile kanser evrelemesi; bilgisayarlı tomografi, pozitron emisyon tomografi ve bilgisayarlı tomografi veya manyetik rezonans görüntüleme de uzak metastaz saptanmayan olgularda endikedir. Endoskopik ultrosonografi ile gastrointestinal sistem kanserlerinin evrelemesinde tümör nod metastaz sınıflaması kullanılır. Yaklaşık olarak bütün gastrointestinal sistem kanserlerinde T evrelemesinde endoskopik ultrosonografinin tanısal doğruluk oranı %85, N evrelemesinde ise doğruluk oranı %75'dir. Kanserlerin doğru evrelenmesi önemlidir çünkü; prognoz hakkında bilgi sağlar ve tedaviye yön verebilmektedir. Ek olarak endoskopik ultrosonografi yardımıyla malign görünümdeki lenf nodlarından iğne aspirasyonu yapılır ve bu sayede N evrelemesinin tanısal doğruluğu artar.

Keywords

Endoskopik ultrasonografi, kanser evrelemesi, gastrointestinal sistem kanserleri

References

• Fischbach W, Al-Taie O. Staging role of EUS. Best Pract Res Clin Gastro- enterol 2010; 24: 13-7.
• Greene FL, Page DL, Fleming ID, et al, editors. AJCC cancer staging ma- nual, 6thedition. New York: Springer, 2002.
• Sobin LH, Wittekind CL, editors. TNM classification of malignant tu- mors, 6thedition. New York: John Wiley & Sons, 2002.
• Veuillez V, Rougier P, Seitz JF. The multidisciplinary management of gastrointestinal cancer. Multimodal treatment of oesophageal cancer. Best Pract Res Clin Gastroenterol 2007; 21: 947-63.
• Siemsen M, Svendsen LB, Knigge U, et al. A prospective randomized comparison of curved array and radial echoendoscopy in patients with esophageal cancer. Gastrointest Endosc 2003; 58: 671-6.
• Matthes K, Bounds BC, Collier K, et al. EUS staging of upper GI malig- nancies: results of a prospective randomized trial. Gastrointest Endosc 2006; 64: 496-502.
• Pech O, Günter E, Ell C. Endosonography of high-grade intra-epithelial neoplasia/early cancer. Best Pract Res Clin Gastroenterol 2009; 23: 639- 47.
• Hasegawa N, Niwa Y, Arisawa T, et al. Preoperative staging of superficial esophageal carcinoma: comparison of an ultrasound probe and standard endoscopic ultrasonography. Gastrointest Endosc 1996; 44: 388-93.
• Kawano T, Ohshima M, Iwai T. Early esophageal carcinoma: endoscopic ultrasonography using the sonoprobe. Abdom Imaging 2003; 28: 477- 85.
• Murata Y, Suzuki S, Ohta M, et al. Small ultrasonic probes for determi- nation of the depth of superficial esophageal cancer.Gastrointest Endosc 1996; 44: 23-8.
• Chemaly M, Scalone O, Durivage G, et al. Miniprobe EUS in the prethe- rapeutic assessment of early esophageal neoplasia. Endoscopy 2008; 40: 2-6.
• Rampado S, Bocus P, Battaglia G, et al. Endoscopic ultrasound: accuracy in staging superficial carcinomas of the esophagus. Ann Thorac Surg 2008; 85: 251-6.
• May A, Gunter E, Roth F, et al. Accuracy of staging in early oesophage- al cancer using high resolution endoscopy and high resolution endoso- nography: a comparative, prospective, and blinded trial. Gut 2004; 53: 634-40.
• Larghi A, Lightdale CJ, Memeo L, et al. EUS followed by EMR for staging of high-grade dysplasia and early cancer in Barrett’s esophagus. Gastro- intest Endosc 2005; 62: 16-23.
• Esaki M, Matsumoto T, Moriyama T, et al. Probe EUS for the diagnosis of invasion depth in superficial esophageal cancer: a comparison betwe- en a jelly-filled method and a water-filled balloon method. Gastrointest Endosc 2006; 63: 389-95.
• van Vliet EP, Heijenbrok-Kal MH, Hunink MG, et al. Staging investigati- ons for oesophageal cancer: a meta-analysis. Br J Cancer 2008; 98: 547-57.
• Catalano MF, Sivak MV Jr, Rice T, et al. Endosonographic features pre- dictive of lymph node metastasis. Gastrointest Endosc 1994; 40: 442-6.
• Bhutani, MS, Hawes, RH & Hoffman, BJ. A comparison of the accuracy of echo features during endoscopic ultrasound (EUS) and EUS-guided fi- ne-needle aspiration for diagnosis of malignant lymph node invasion. Gastrointest Endosc 1997; 45: 474-9.
• Puli SR, Reddy JB, Bechtold ML, et al. Staging accuracy of esophageal cancer by endoscopic ultrasound: a meta-analysis and systematic review. World J Gastroenterol 2008; 14: 1479-90.
• van Vliet EP, Eijkemans MJ, Kuipers EJ, et al. Publication bias does not play a role in the reporting of the results of endoscopic ultrasound sta- ging of upper gastrointestinal cancers. Endoscopy 2007; 39: 325-32.
• Vazquez-Sequeiros E, Wiersema MJ, Clain JE et al. Impact of lymph no- de staging on therapy of esophageal carcinoma. Gastroenterology 2003; 125: 1626-35.
• Lightdale CJ, Kulkarni KG. Role of endoscopic ultrasonography in the staging and follow-up of esophageal cancer. J Clin Oncol 2005; 23: 4483-9.
• Romagnuolo J, Scott J, Hawes RH, et al. Helical CT versus EUS with fi- ne needle aspiration for celiac nodal assessment in patients with esopha- geal cancer. Gastrointest Endosc 2002;55:648-54.
• Swisher SG, Maish M, Erasmus JJ, et al. Utility of PET, CT, and EUS to identify pathologic responders in esophageal cancer. Ann Thorac Surg 2004; 78: 1152-60.
• Kalha I, Kaw M, Fukami N, et al. The accuracy of endoscopic ultraso- und for restaging esophageal carcinoma after chemoradiation therapy. Cancer 2004; 101: 940-7.
• Cerfolio RJ, Bryant AS, Ohja B, et al. The accuracy of endoscopic ultra- sonography with fine-needle aspiration, integrated positron emission to- mography with computed tomography, and computed tomography in restaging patients with esophageal cancer after neoadjuvant chemoradi- otherapy. J Thorac Cardiovasc Surg 2005; 129: 1232-41.
• Ribeiro A, Franceschi D, Parra J, et al. Endoscopic ultrasound restaging after neoadjuvant chemotherapy in esophageal cancer. Am J Gastroente- rol 2006; 101: 1216-21.
• Bektas M, Oruc N, Qiao W, et al. Which technique predicts histopatho- logic regression after neoadjuvant therapy for esophageal cancer? DDW 2010, May 1-5, 2010: New Orleans W1882 (abstract).
• Catalano MF, Van Dam J, Sivak MV Jr. Malignant esophageal strictures: staging accuracy of endoscopic ultrasonography. Gastrointest Endosc 1995; 41: 535-9.
• Catalano MF, Alcocer E, Chak A. et al. Evaluation of metastatic celiac axis lymph nodes in patients with esophageal carcinoma: accuracy of EUS. Gastrointest Endosc 1999; 50: 352-6.
• Raju RP, Jaganmohan S, Bektas M, et l. Prognostic implications of high grade malignant esophageal strictures in esophageal cancer. DDW 2010, May 1-5, 2010: New Orleans S 1501 (abstract).
• Yasuda, K. EUS in the detection of early gastric cancer. Gastrointest En- dosc. 2002 Oct; 56(4 Suppl): S68-75.
• Yasuda K, Nakajima M, Kawai K. Endoscopic diagnosis and treatment of early gastric cancer using endoscopic ultrasonography (EUS). Gastroin- test Endosc Clin North Am 1992; 2: 495-507.
• Ichikawa T, Kudo M, Matsui S, et al. Endoscopic ultrasonography with three miniature probes of different frequency is an accurate diagnostic tool for endoscopic submucosal dissection. Hepatogastroenterology 2007; 54: 325-8.
• Kida M, Kikuchi H, Ikeda H, et al. Diagnosis of gastric cancer invasion with three-dimensional endoscopic ultrasonography, especially in cases with "SM1" invasion. Stomach and Intesine 2007; 42; 88-98.
• Puli SR, Batapati Krishna Reddy J, Bechtold ML, et al. How good is en- doscopic ultrasound for TNM staging of gastric cancers? A meta-analysis and systematic review. World J Gastroenterol 2008; 14: 4011-9.
• Fujino Y, Nagata Y, Ogino K, Watahiki H. Evaluation of endoscopic ul- trasonography as an indicator for surgical treatment of gastric cancer. J Gastroenterol Hepatol 1999; 14: 540-6.
• Habermann CR, Weiss F, Riecken R, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US. Radio- logy 2004; 230: 465-71.
• Bhandari S, Shim CS, Kim JH, et al. Usefulness of three-dimensional, multidetector row CT (virtual gastroscopy and multiplanar reconstructi- on) in the evaluation of gastric cancer: a comparison with conventional endoscopy, EUS, and histopathology. Gastrointest Endosc 2004; 59: 619-26.
• Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a syste- matic review. J Clin Oncol 2007; 25: 2107-16.
• Lightdale CJ, Botet JF, Kelsen DP, et al. Diagnosis of recurrent upper gas- trointestinal cancer at the surgical anastomosis by endoscopic ultraso- und. Gastrointest Endosc 1989; 35: 407-12.
• Park SR, Lee JS, Kim CG, et al. Endoscopic ultrasound and computed to- mography in restaging and predicting prognosis after neoadjuvant che- motherapy in patients with locally advanced gastric cancer. Cancer 2008; 112: 2368-76.
• Shami VM, Parmar KS,Waxman I. Clinical impact of endoscopic ultraso- und and endoscopic ultrasound-guided fine-needle aspiration in the ma- nagement of rectal carcinoma. Dis Colon Rectum 2004; 47: 59-65.
• Müller C, Kähler G, Scheele J. Endosonographic examination of gastro- intestinal anastomoses with suspected locoregional tumor recurrence. Surg Endosc 2000; 14: 45-50.
• Beynon J, Mortensen NJ, Foy DM, et al. Preoperative assessment of me- sorectal lymph node involvement in rectal cancer. Br J Surg 1989; 76: 276-9.
• Thaler W, Watzka S, Martin F, et al. Preoperative staging of rectal can- cer by endoluminal ultrasound vs. magnetic resonance imaging. Prelimi- nary results of a prospective, comparative study. Dis Colon Rectum 1994; 37: 1189-93.
• Fuchsjager MH, Maier AG, Schima W, et al. Comparison of transrectal sonography and double-contrast MR imaging when staging rectal cancer. Am J Roentgenol 2003; 181: 421-7.
• Ferri M, Laghi A, Mingazzini P, et al. Pre-operative assessment of extra- mural invasion and sphincteral involvement in rectal cancer by magne- tic resonance imaging with phased-array coil. Colorectal Dis 2005; 7: 387-93.
• Radovanovic Z, Breberina M, Petrovic T, et al. Accuracy of endorectal ul- trasonography in staging locally advanced rectal cancer after preoperati- ve chemoradiation. Surg Endosc 2008; 22: 2412-5.
• Vanagunas A, Lin DE, Stryker SJ. Accuracy of endoscopic ultrasound for restaging rectal cancer following neoadjuvant chemoradiation therapy. Am J Gastroenterol 2004; 99: 109-12.
• Maor Y, Nadler M, Barshack I, et al. Endoscopic ultrasound staging of rectal cancer: diagnostic value before and following chemoradiation. J Gastroenterol Hepatol 2006; 21: 454-8.
• Hünerbein M, Handke T, Ulmer C, Schlag PM. Impact of miniprobe ul- trasonography on planning of minimally invasive surgery for gastric and colonic tumors. Surg Endosc 2004;18: 601-5.