Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer - 23/08/11
Reprint requests: Rajesh N. Keswani, MD, Division of Gastroenterology, 676 North St. Clair, Suite 14-016, Chicago, IL 60611.St. Louis, Missouri, USA
Abstract |
Background |
Although EUS-guided FNA (EUS-FNA) and 18F-fluorodeoxyglucose–positron emission tomography (FDG-PET) are both used in the staging of esophageal cancer, the utility of routinely performing both tests is unclear.
Objectives |
The primary aim of the study was to determine the benefit of routine FDG-PET for esophageal cancer nodal staging in patients undergoing EUS-FNA. The secondary objective was to determine EUS criteria that selectively identify patients in whom PET yields additional information.
Design |
Retrospective chart review.
Setting |
Tertiary-care academic medical center.
Patients and Interventions |
All patients who underwent both EUS and PET for initial staging of esophageal cancer between April 2003 and August 2007.
Main Outcome Measurements |
EUS and PET detection of malignant lymph nodes and distant metastases.
Results |
Of 242 patients who underwent esophageal EUS for a malignant indication, 148 also underwent PET within 30 days. EUS detected locoregional-node disease by EUS criteria or cytology in 92 patients, and PET was positive in a minority of these patients (n = 41 [45%]). For celiac-node staging, PET was positive in 2 of 17 patients (12%) with celiac-node involvement detected by EUS. EUS was also significantly more sensitive than PET in the detection of nodal disease confirmed by cytology or histology (86% vs 44%). PET did not alter nodal staging in any patient with complete EUS-FNA. PET identified distant metastases only in those patients with incomplete EUS or nodal disease detected by EUS.
Limitations |
Single institution, retrospective analysis.
Conclusions |
The addition of PET to a complete EUS examination did not alter regional-node or celiac-node staging. PET performance in overall staging is strongly associated with EUS assessment of lymph nodes.
Le texte complet de cet article est disponible en PDF.Abbreviations : AJCC, EUS-FNA, FDG, PET
Plan
| DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: S. Edmundowicz: Receives research support and acts as a consultant for Olympus and receives grant and equipment support from Cook Endoscopy; D. Early, R. Azar: Received honoraria from Olympus and Cook Endoscopy. All other authors disclosed no financial relationships relevant to this publication. |
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| If you want to chat with an author of this article, you may contact him at rajman@gmail.com. |
Vol 69 - N° 7
P. 1210-1217 - juin 2009 Retour au numéro
Article précédent
- Colonoscopy preparation
- Prepared by: ASGE TECHNOLOGY COMMITTEE, Petar Mamula, Douglas G. Adler, Jason D. Conway, David L. Diehl, Francis A. Farraye, Sergey V. Kantsevoy, Vivek Kaul, Sripathi R. Kethu, Richard S. Kwon, Sarah A. Rodriguez, William M. Tierney
- EUS-guided sampling of suspected GI stromal tumors
- Katherine M. Hoda, Sarah A. Rodriguez, Douglas O. Faigel
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