TY - JOUR
T1 - Impact of EUS-guided FNA on management of gastric carcinoma
AU - Hassan, Hazem
AU - Vilmann, Peter
AU - Sharma, Vijay
N1 - 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Background: EUS is an integral part of the pretherapeutic evaluation program for patients with upper GI cancer. Objective: To evaluate the impact of EUS-guided FNA on the clinical management of patients with gastric cancer. Design: The study included patients with confirmed gastric carcinoma who were referred to the Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Copenhagen, Denmark, during a 6-year period (2001-2007). Setting: The patients underwent standard pretherapeutic evaluation. If no signs of incurability were detected, the patients were offered EUS and EUS-guided FNA. EUS-guided FNA was performed when lymph nodes or lesions were considered to be distant metastases. A board of surgeons was asked to evaluate the management of the patients after the results obtained by EUS-guided FNA were revealed. Patients: This study involved 234 patients with gastric carcinoma. Intervention: EUS-guided FNA. Main Outcome Measurements: Number of patients with distant metastasis diagnosed by EUS-guided FNA, with the avoidance of unnecessary surgery. Results: A total of 81 consecutive patients underwent EUS-guided FNA. Ninety-nine lesions were targeted, and 61 (62%) of these lesions were found to be malignant. In 38 of 81 patients (42%) distant metastases were confirmed by EUS-guided FNA. As judged by the board of surgeons, EUS-guided FNA changed the management plan in 34 of 234 patients (15%). Limitation: The positive EUS-guided FNA diagnoses were not surgically verified. Conclusion: EUS-guided FNA is a very important modality and should be integrated as a routine procedure in the preoperative staging algorithm of gastric cancer.
AB - Background: EUS is an integral part of the pretherapeutic evaluation program for patients with upper GI cancer. Objective: To evaluate the impact of EUS-guided FNA on the clinical management of patients with gastric cancer. Design: The study included patients with confirmed gastric carcinoma who were referred to the Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Copenhagen, Denmark, during a 6-year period (2001-2007). Setting: The patients underwent standard pretherapeutic evaluation. If no signs of incurability were detected, the patients were offered EUS and EUS-guided FNA. EUS-guided FNA was performed when lymph nodes or lesions were considered to be distant metastases. A board of surgeons was asked to evaluate the management of the patients after the results obtained by EUS-guided FNA were revealed. Patients: This study involved 234 patients with gastric carcinoma. Intervention: EUS-guided FNA. Main Outcome Measurements: Number of patients with distant metastasis diagnosed by EUS-guided FNA, with the avoidance of unnecessary surgery. Results: A total of 81 consecutive patients underwent EUS-guided FNA. Ninety-nine lesions were targeted, and 61 (62%) of these lesions were found to be malignant. In 38 of 81 patients (42%) distant metastases were confirmed by EUS-guided FNA. As judged by the board of surgeons, EUS-guided FNA changed the management plan in 34 of 234 patients (15%). Limitation: The positive EUS-guided FNA diagnoses were not surgically verified. Conclusion: EUS-guided FNA is a very important modality and should be integrated as a routine procedure in the preoperative staging algorithm of gastric cancer.
U2 - 10.1016/j.gie.2009.10.044
DO - 10.1016/j.gie.2009.10.044
M3 - Journal article
SN - 1085-8741
SN - 1097-6779
VL - 71
SP - 500
EP - 504
JO - Annual of Gastrointestinal Endoscopy
JF - Annual of Gastrointestinal Endoscopy
IS - 3
ER -
