Value of EUS in Determining Curative Resectability in Reference to CT and FDG-PET: The Optimal Sequence in Preoperative Staging of Esophageal Cancer?Schreurs, L. M. A., Janssens, A. C. J. W., Groen, H., Fockens, P., van Dullemen, H. M., Henegouwen, M. I. V. B., Sloof, G. W., Pruim, J., van Lanschot, J. J. B., Steyerberg, E. W. & Plukker, J. T. M., Dec-2016, In : Annals of Surgical Oncology. 23, p. S1021-S1028 8 p.
Research output: Contribution to journal › Article › Academic › peer-review
- Methods in Medicines evaluation & Outcomes research (M2O)
- Reproductive Origins of Adult Health and Disease (ROAHD)
- Center for Medical Imaging (CMI)
- Guided Treatment in Optimal Selected Cancer Patients (GUTS)
- Damage and Repair in Cancer Development and Cancer Treatment (DARE)
- Value, Affordability and Sustainability (VALUE)
Background. The separate value of endoscopic ultrasonography (EUS), multidetector computed tomography (CT), and (18) F-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.
|Number of pages||8|
|Journal||Annals of Surgical Oncology|
|Publication status||Published - Dec-2016|
- POSITRON-EMISSION-TOMOGRAPHY, DISTANT METASTASES, ADDITIONAL VALUE, F-18-FLUORODEOXYGLUCOSE, EPIDEMIOLOGY, ONCOLOGY, THERAPY, SCANS