Usefulness of Endoscopic Ultrasonography in Determining the Depth of Invasion and Indication for Endoscopic Treatment of Early Gastric Cancer

Journal of Clinical Gastroenterology Volume 43 Issue 4 Page 318-322 published_at 2009
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Title ( eng )
Usefulness of Endoscopic Ultrasonography in Determining the Depth of Invasion and Indication for Endoscopic Treatment of Early Gastric Cancer
Creator
Mouri Ritsuo
Oka Shiro
Source Title
Journal of Clinical Gastroenterology
Volume 43
Issue 4
Start Page 318
End Page 322
Abstract
Introduction: Endoscopic ultrasonography (EUS) is a useful method for visualizing features of gastric cancer. However, a previously reported classification system tended to result in overstaging. We investigated the usefulness of EUS for evaluation of the depth of gastric cancer invasion and indications for endoscopic treatment. Methods: Accuracy of EUS for determining the depth of invasion and incidences of a positive basal margin were assessed in 235 patients who underwent endoscopic treatment or surgery for gastric cancer. The EUS-determined depth of invasion was classified its follows: EUS-M (lesion confined to sonographic layers 1 and 2); EUS-M/SM border (lesion with changes in sonographic layer 3 but no deeper than 1 min); EUS-SM (lesion with changes in sonographic layer 3 deeper than 1 mm); or EUS-AD (lesion with changes in sonographic layer 4 or 5). Results: Accuracy of EUS for determining the depth of invasion was as follows: EUS-M, 99% were M and SM1 lesions; EUS-M/SM border, 87% were M and SM1 lesions; EUS-SM, 91% were SM2 lesions; EUS-AD, 100% were muscularis propria or deeper lesions. There was no EUS-M or EUS-M/SM border lesion for which endoscopic treatment resulted in it positive basal margin. Conclusions: EUS is useful for accurately determining the depth of invasion of gastric cancer. When there are no endoscopically determined ulcerous changes. endoscopic treatment should be considered for EUS-M and EUS-M/SM border lesions, and EUS-SM lesions should be treated surgically.
Keywords
early gastric cancer. endoscopic ultrasound. endoscopic treatment
NDC
Medical sciences [ 490 ]
Language
eng
Resource Type journal article
Publisher
Lippincott Wolliams & Wilkins
Date of Issued 2009
Publish Type Author’s Original
Access Rights open access
Source Identifier
[ISSN] 0192-0790
[DOI] 10.1097/MCG.0b013e3181775966
[NCID] AA00257261
[DOI] http://dx.doi.org/10.1097/MCG.0b013e3181775966