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  • Title: Impact of EUS-guided FNA on management of gastric carcinoma.
    Author: Hassan H, Vilmann P, Sharma V.
    Journal: Gastrointest Endosc; 2010 Mar; 71(3):500-4. PubMed ID: 20189507.
    Abstract:
    BACKGROUND: EUS is an integral part of the pretherapeutic evaluation program for patients with upper GI cancer. OBJECTIVE: To evaluate the impact of EUS-guided FNA on the clinical management of patients with gastric cancer. DESIGN: The study included patients with confirmed gastric carcinoma who were referred to the Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Copenhagen, Denmark, during a 6-year period (2001-2007). SETTING: The patients underwent standard pretherapeutic evaluation. If no signs of incurability were detected, the patients were offered EUS and EUS-guided FNA. EUS-guided FNA was performed when lymph nodes or lesions were considered to be distant metastases. A board of surgeons was asked to evaluate the management of the patients after the results obtained by EUS-guided FNA were revealed. PATIENTS: This study involved 234 patients with gastric carcinoma. INTERVENTION: EUS-guided FNA. MAIN OUTCOME MEASUREMENTS: Number of patients with distant metastasis diagnosed by EUS-guided FNA, with the avoidance of unnecessary surgery. RESULTS: A total of 81 consecutive patients underwent EUS-guided FNA. Ninety-nine lesions were targeted, and 61 (62%) of these lesions were found to be malignant. In 38 of 81 patients (42%) distant metastases were confirmed by EUS-guided FNA. As judged by the board of surgeons, EUS-guided FNA changed the management plan in 34 of 234 patients (15%). LIMITATION: The positive EUS-guided FNA diagnoses were not surgically verified. CONCLUSION: EUS-guided FNA is a very important modality and should be integrated as a routine procedure in the preoperative staging algorithm of gastric cancer.
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