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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| _version_ | 1864513462886989824 |
|---|---|
| author | Azar, Riad |
| author2 | Keswani, Rajesh N. Early, Dayna S. Edmundowicz, Steven A. Meyers, Bryan F. Sharma, Akash |
| author2_role | author author author author author |
| author_facet | Azar, Riad Keswani, Rajesh N. Early, Dayna S. Edmundowicz, Steven A. Meyers, Bryan F. Sharma, Akash |
| author_role | author |
| dc.creator.none.fl_str_mv | Azar, Riad Keswani, Rajesh N. Early, Dayna S. Edmundowicz, Steven A. Meyers, Bryan F. Sharma, Akash |
| dc.date.none.fl_str_mv | 2009 2016-06-21T09:47:19Z 2016-06-21T09:47:19Z 2016-06-21 |
| dc.identifier.none.fl_str_mv | 0016-5107 http://hdl.handle.net/10725/4118 http://dx.doi.org/10.1016/j.gie.2008.08.016 Keswani, R. N., Early, D. S., Edmundowicz, S. A., Meyers, B. F., Sharma, A., Govindan, R., ... & Azar, R. R. (2009). Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer. Gastrointestinal endoscopy, 69(7), 1210-1217. http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://www.sciencedirect.com/science/article/pii/S0016510708024243 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Gastrointestinal Endoscopy |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_2d64bc9397fe1e3f6141cb800e4ea408 |
| identifier_str_mv | 0016-5107 Keswani, R. N., Early, D. S., Edmundowicz, S. A., Meyers, B. F., Sharma, A., Govindan, R., ... & Azar, R. R. (2009). Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer. Gastrointestinal endoscopy, 69(7), 1210-1217. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/4118 |
| publishDate | 2009 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancerAzar, RiadKeswani, Rajesh N.Early, Dayna S.Edmundowicz, Steven A.Meyers, Bryan F.Sharma, AkashBackground: 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.PublishedN/A2016-06-21T09:47:19Z2016-06-21T09:47:19Z20092016-06-21Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0016-5107http://hdl.handle.net/10725/4118http://dx.doi.org/10.1016/j.gie.2008.08.016Keswani, R. N., Early, D. S., Edmundowicz, S. A., Meyers, B. F., Sharma, A., Govindan, R., ... & Azar, R. R. (2009). Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer. Gastrointestinal endoscopy, 69(7), 1210-1217.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://www.sciencedirect.com/science/article/pii/S0016510708024243enGastrointestinal Endoscopyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/41182021-03-19T10:03:20Z |
| spellingShingle | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer Azar, Riad |
| status_str | publishedVersion |
| title | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer |
| title_full | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer |
| title_fullStr | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer |
| title_full_unstemmed | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer |
| title_short | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer |
| title_sort | Routine positron emission tomography does not alter nodal staging in patients undergoing EUS-guided FNA for esophageal cancer |
| url | 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 |