Endoscopic ultrasound for staging of colonic cancer proximal to the rectum: A systematic review and meta-analysis

TY - JOUR

T1 - Endoscopic ultrasound for staging of colonic cancer proximal to the rectum

T2 - A systematic review and meta-analysis

AU - Malmstrøm, Marie Louise

AU - Saftoiu, Adrian

AU - Vilmann, Peter

AU - Klausen, Tobias Wirenfeldt

AU - Gögenur, Ismail

PY - 2016/9/1

Y1 - 2016/9/1

N2 - BACKGROUND AND OBJECTIVES: Treatment of colonic cancer patients is highly dependent on the depth of tumor invasion (T-stage) as well as the extension of lymph node involvement (N-stage). We aimed to systematically review the accuracy of endoscopic ultrasound (EUS) for staging of colonic cancer proximal to the rectum.PATIENTS AND METHODS: Men and women with colonic adenocarcinomas were included in the study. EUS staging was compared to histopathology as the gold standard. Outcome measures were T- and N-staging accuracies. Articles were searched in PubMed, Web of Science, The Cochrane Library, and EMBASE.RESULTS: Six studies were identified comparing EUS staging of colonic cancer to histopathology. The pooled-staging sensitivity and specificity were 0.90 and 0.98 for T1 tumors, 0.67 and 0.96 for T2 tumors, and 0.97 and 0.83 for T3/T4 tumors, respectively. Sensitivity and specificity for N + disease were 0.59 and 0.78, respectively.CONCLUSIONS: EUS is a feasible method for T-staging of cancers of the colon proximal to the rectum. The accuracy of lymph node staging needs to be verified by prospective multicenter studies including larger patient populations.

AB - BACKGROUND AND OBJECTIVES: Treatment of colonic cancer patients is highly dependent on the depth of tumor invasion (T-stage) as well as the extension of lymph node involvement (N-stage). We aimed to systematically review the accuracy of endoscopic ultrasound (EUS) for staging of colonic cancer proximal to the rectum.PATIENTS AND METHODS: Men and women with colonic adenocarcinomas were included in the study. EUS staging was compared to histopathology as the gold standard. Outcome measures were T- and N-staging accuracies. Articles were searched in PubMed, Web of Science, The Cochrane Library, and EMBASE.RESULTS: Six studies were identified comparing EUS staging of colonic cancer to histopathology. The pooled-staging sensitivity and specificity were 0.90 and 0.98 for T1 tumors, 0.67 and 0.96 for T2 tumors, and 0.97 and 0.83 for T3/T4 tumors, respectively. Sensitivity and specificity for N + disease were 0.59 and 0.78, respectively.CONCLUSIONS: EUS is a feasible method for T-staging of cancers of the colon proximal to the rectum. The accuracy of lymph node staging needs to be verified by prospective multicenter studies including larger patient populations.

U2 - 10.4103/2303-9027.191610

DO - 10.4103/2303-9027.191610

M3 - Review

C2 - 27803903

SN - 2226-7190

VL - 5

SP - 307

EP - 314

JO - Endoscopic Ultrasound

JF - Endoscopic Ultrasound

IS - 5

ER -