Blackshaw, G.; Weaver, S.; Edwards, P.; Lewis, W.; Allison, M.; Roberts, A.; Thomas, G.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA87
Academic Journal
Aims: Endoluminal ultrasound (EUS) has been championed as the answer to the limitations of computed tomography (CT} in assessing tumour infiltration (T stage) and lymph node involvement (N stage) in patients with oesophageal cancer. However, the precise strength of agreement between EUS, special interest CT, and the true histopothological stage has not been reported. Methods: Sixty consecutive patients (median age 61 year, 35 m, 41 adeno, 19 squamous cell) with oesophageal cancer were studied prospectively. Each patient underwent preoperative CT (Siemens Somatom +4) performed by the specialist multidisciplinary team consultant radiologist, and EUS (Olympus UM-20, and MH-908-1). The strength of the agreement between the perceived radiological stage and the true histopathological stage of the resected specimen was determined by the weighted Kappa statistic (Kw). Results: When CT and EUS concurred, the accuracy of the radiological stage was enhanced twofold (T Kw 0.51, N Kw 0.80, p < 0.0001). Conclusion: These data reinforce the fact that the modalities of CT and EUS are complimentary, and highlights the value of multidisciplinary teams in relining preoperative diagnoses and optimising the treatment of patients with oesophageal cancer.


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