Accuracy of Endoscopic Ultrasonography for Determination of Tumor Invasion Depth in Gastric Cancer

Background: Gastric cancer (GC) is one the common lethal cancers in Iran. Detection of GC in the early stageswould assesses to improve the survival of patients. In this study, we attempt to evaluate the accuracy of EUS indetection depth of invasion of GC among Iranian Patients. Materials and
Methods: This study is a retrospectivestudy of patients with pathologically confirmed GC. They underwent EUS before initiating the treatment. Theaccuracy of EUS and agreement between the two methods was evaluated by comparing pre treatment EUSfinding with post operative histopathological results.
Results: The overall accuracy of EUS for T and N stagingwas 67.9% and 75.47, respectively. Underestimation and overestimation was seen in 22 (14.2%) and 40 (25.6%)respectively. The EUS was more accurate in large tumors and the tumors located in the middle and lower parts ofthe stomach. The EUS was more sensitive in T3 staging. The values of weighted Kappa from the T and N stagingwere 0.53 and 0.66, respectively.
Conclusions: EUS is a useful modality for evaluating the depth of invasion ofGC. The accuracy of EUS was higher if the tumor was located in the lower parts of the stomach and the size ofthe tumor was more than 3 cm. Therefore, judgments made upon other criteria evaluated in this study need tobe reconsidered.