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- Title
The examiner's learning effect and its influence on the quality of endoscopic ultrasonography in carcinoma of the esophagus and gastric cardia.
- Authors
Schlick, T.; Heintz, A.; Junginger, Th.; Junginger, T
- Abstract
<bold>Background: </bold>The preoperative diagnosis of tumors of the esophagus and the gastric cardia is an important element in their stage-oriented therapy. The goal of the present study was to evaluate the accuracy of endosonographic ultrasound (EUS) and to test its usefulness in tumor staging and the assessment of operability.<bold>Methods: </bold>A total of 139 tumors were scanned via EUS by one examiner </=14 days prior to resection (TNM staging per UICC, 1987).<bold>Results: </bold>The accuracy for completely traversable tumors was 60.8% for T1, 82.1% for T2, 77.5% for T3, and 33% for T4 stages. This accuracy was somewhat reduced in cases of nontraversable tumor stenosis (51.9%). In T staging, a significant case-dependent improvement in accuracy to 89.5% was found; this was regarded as a learning effect. In N staging, we considered only those tumors that were resected by the transthoracic approach with systematic node dissection and complete EUS (n = 80). N-stage accuracy (T1-T4) was 71.3%, and no improvement could be shown. To assess operability, discrimination between T1/T2 and T3/T4 tumors is crucial. Accuracy, sensitivity, and specifity can thus be improved significantly.<bold>Conclusions: </bold>The quality of EUS depends on the experience of the examiner. Reliable results can be obtained after >75 examinations have been done. EUS is a valuable tool in tumor staging when it is performed by an experienced examiner or under the direct supervision of such a person.
- Subjects
CLINICAL competence; ENDOSCOPIC ultrasonography; ESOPHAGEAL tumors; LEARNING; RESEARCH evaluation; STOMACH; STOMACH tumors; TUMOR classification
- Publication
Surgical Endoscopy, 1999, Vol 13, Issue 9, p894
- ISSN
0930-2794
- Publication type
journal article
- DOI
10.1007/s004649901128