Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer
Background: Although EUS-guided FNA (EUS-FNA) and 18F-fluorodeoxyglucose–positron emission tomography (FDG-PET) are both used in the staging of esophageal cancer, the utility of routinely performing both tests is unclear. Objectives: The primary aim of the study was to determine the benefit of routi...
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| مؤلفون آخرون: | , , , , |
| التنسيق: | article |
| منشور في: |
2009
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| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/4118 http://dx.doi.org/10.1016/j.gie.2008.08.016 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://www.sciencedirect.com/science/article/pii/S0016510708024243 |
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| الملخص: | Background: Although EUS-guided FNA (EUS-FNA) and 18F-fluorodeoxyglucose–positron emission tomography (FDG-PET) are both used in the staging of esophageal cancer, the utility of routinely performing both tests is unclear. Objectives: The primary aim of the study was to determine the benefit of routine FDG-PET for esophageal cancer nodal staging in patients undergoing EUS-FNA. The secondary objective was to determine EUS criteria that selectively identify patients in whom PET yields additional information. Design: Retrospective chart review. Setting: Tertiary-care academic medical center. Patients and Interventions: All patients who underwent both EUS and PET for initial staging of esophageal cancer between April 2003 and August 2007. Main Outcome Measurements: EUS and PET detection of malignant lymph nodes and distant metastases. Results: Of 242 patients who underwent esophageal EUS for a malignant indication, 148 also underwent PETwithin 30 days. EUS detected locoregional-node disease by EUS criteria or cytology in 92 patients, and PETwas positive in a minority of these patients (n Z 41 [45%]). For celiac-node staging, PETwas positive in 2 of 17 patients (12%) with celiacnode involvement detected by EUS. EUS was also significantly more sensitive than PETin the detection of nodal disease confirmed by cytology or histology (86% vs 44%). PET did not alter nodal staging in any patient with complete EUSFNA. PET identified distant metastases only in those patients with incomplete EUS or nodal disease detected by EUS. Limitations: Single institution, retrospective analysis. Conclusions: The addition of PET to a complete EUS examination did not alter regional-node or celiac-node staging. PET performance in overall staging is strongly associated with EUS assessment of lymph nodes. |
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