Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer

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<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Preoperative accurate diagnosis of the T and N stages in early gastric cancer (EGC) is important in determining the application of various limited treatments. The aim of this study is to analyze the accuracy of T and N staging of EGC with esophagogastroduodenoscopy (EGD), Stomach protocol CT (S‐CT), and endoscopic ultrasonography (EUS), and the factors influencing the accuracy.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Four hundred and thirty‐four patients preoperatively diagnosed as EGC using EGD or S‐CT and undergoing curative gastrectomy at Seoul National University Hospital in 2005 were included. The T and N stage reviewed by experienced personnel were compared with the surgical pathology.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The predictive values for EGC of EGD, S‐CT, and EUS were 87.4%, 92.2%, and 94.1%, respectively. The predictive values for node negativity of S‐CT, and EUS were 90.1% and 92.6%, respectively. The factors leading to underestimation of T stage with EGD were the upper third location, the size greater than 2 cm, and diffuse type of tumor. Those with S‐CT were female sex, the upper third location and lesion size greater than 2 cm.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Before applying limited treatment for EGC, a surgeon should consider the risk factors of underestimation of T stage with EGD or S‐CT. J. Surg. Oncol. 2009;99:20–27. © 2008 Wiley‐Liss, Inc.</jats:p></jats:sec>

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