Accuracy of preoperative endoscopy in determining tumor location required for surgical planning for esophagogastric junction cancer

Koichi Okumura, Yudai Hojo, Toshihiko Tomita, Tsutomu Kumamoto, Tatsuro Nakamura, Yasunori Kurahashi, Yoshinori Ishida, Seiichi Hirota, Hiroto Miwa, Hisashi Shinohara

研究成果: ジャーナルへの寄稿学術論文査読

4 被引用数 (Scopus)

抄録

Purpose: The surgical strategy for esophagogastric junction (EGJ) cancer depends on the tumor location as measured relative to the EGJ line. The purpose of this study was to clarify the accuracy of diagnostic endoscopy in different clinicopathological backgrounds. Methods: Subjects were 74 consecutive patients with abdominal esophagus to upper gastric cancer who underwent surgical resection. Image-enhanced endoscopy with narrow-band imaging (NBI) was used to determine the EGJ line, prioritizing the presence of palisade vessels, followed by the upper end of gastric folds, as a landmark. The relative positional relationship between the tumor epicenter and the EGJ line was classified into six categories, and the agreement between endoscopic and pathologic diagnoses was examined to evaluate prediction accuracy. Results: The concordance rate of 69 eligible cases was 87% with a kappa coefficient (K) of 0.81. The palisade vessels were observed in 62/69 patients (89.9%). Of the 37 pathological EGJ cancers centered within 2 cm above and below the EGJ line, Barrett’s esophagus was found to be a significant risk factor for discordance (risk ratio, 4.40; p = 0.042); the concordance rate of 60% (K = 0.50) in the Barrett’s esophagus group was lower than the rate of 91% (K = 0.84) in the non-Barrett’s esophagus group. In five of six discordant cases, the EGJ line was estimated to be proximal to the actual line. Conclusion: Diagnostic endoscopy is beneficial for estimating the location of EGJ cancer, with a risk of underestimating esophageal invasion length in patients with Barrett’s esophagus.

本文言語英語
論文番号3371
ジャーナルJournal of Clinical Medicine
10
15
DOI
出版ステータス出版済み - 01-08-2021
外部発表はい

All Science Journal Classification (ASJC) codes

  • 医学一般

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