Endoscopic ultrasound for staging of esophageal and gastric cancers

Abstract

Background: Gastric adenocarcinoma (GAC) and esophageal adenocarcinoma (EAC) are one of the
leading causes of mortality from gastrointestinal cancer worldwide. Endoscopic ultrasound (EUS) has
proved to be a valuable tool for preoperative staging of GAC and EAC in selected cases.
Objective: The aim of this study was to evaluate the usefulness of EUS for staging of EAC and GAC and
selecting patients who are candidates for neoadjuvant therapy, as compared with the previous stage before the implementation of EUS, in a surgical center in Argentina.
Material and methods: Consecutive patients with EAC and GAC between 2013-2019 were included. Patients with criteria of unresectable cancer or who underwent emergency surgery were excluded.
The sample was divided into four groups G1 and G2 (EAC with and without EUS, respectively) and G3 and G4 (GAC with and without EUS, respectively). The clinical and anatomopathological variables and survival were evaluated in all the groups.
Results: A total of 89 patients were included, 40 with EAC (30 in G1 and 10 in G2, and 49 with GAC, 20 in G3 and 29 in G4. Of the patients undergoing EUS staging in G1, 23 (75%) received neoadjuvant therapy vs. 2 patients in G2 (20%) (P ≤ 0.005). Eight patients (40%) in G3 and 2 (7%) in G4 received perioperative chemotherapy (P ≤ 0.005). Lymph node metastases were observed in 9 (30%) of surgical specimens of EAC in G1 and in 60% in G2 (P ≤ 0.005), and in 45% in G3 and G4. After a mean follow-up of 36 months (6-72)