Staging of adenocarcinoma of the gastroesophageal junction

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
K ParryR van Hillegersberg

Abstract

Clinical staging of adenocarcinoma of the gastroesophageal junction (GEJ) determines the curative treatment regimen containing either neoadjuvant chemotherapy or chemoradiotherapy followed by either gastrectomy or esophagectomy. The value of current diagnostic tools is a matter of debate. A prospective database (2003-2013) was used to identify 266 consecutive patients with adenocarcinoma of the GEJ in order to evaluate the accuracy of endoscopic ultrasound (EUS) and computed tomography (CT) regarding tumor localization according to Siewert, nodal status and its consequences on treatment strategy. Overall accuracy in determining tumor localization was 73% for endoscopy/EUS and 61% for CT (p = 0.018). With endoscopy/EUS, the accuracy was 97%, 66% and 75% respectively for type I, II and III. With CT this was respectively 69%, 57% and 80%. The overall accuracy for determining N-status (N0/N+) per patient was 75% for EUS and 71% for CT. Accuracy for determining a positive nodal station in patients without neoadjuvant therapy was 77% for EUS and 71% for CT (p = 0.001). Accuracy for detecting positive upper mediastinal nodes was 80-92%, whereas for peritumoral and abdominal nodes this was 50-80% in both EUS and CT. In 8/266 patients (...Continue Reading

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Citations

Aug 15, 2017·Langenbeck's Archives of Surgery·Andrew M BrownFrancesco Palazzo
Jan 25, 2019·Annals of Surgical Oncology·Jonathan Cools-Lartigue, Lorenzo Ferri
Jun 5, 2018·Annals of Gastroenterological Surgery·Miguel A CuestaJennifer Straatman
Aug 23, 2019·World Journal of Gastrointestinal Oncology·Shun ZhangTetsu Fukunaga
Oct 19, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Toshiro MasudaTimothy R Donahue
Aug 3, 2019·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·I GockelC Wittekind
May 14, 2019·United European Gastroenterology Journal·Juliana M CostaJoão B Soares
Jul 28, 2019·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Thibault VoronUNKNOWN FREGAT working group - FRENCH
Apr 27, 2021·Ultrasound in Medicine & Biology·Alexandre Luis KlamtRichard Ricachenevsky Gurski
Sep 21, 2017·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Jia-Bin WangChang-Ming Huang

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