Mini-probe ultrasonography for the staging of colon cancer. A systematic review and meta-analysis. Tamara MH Gall, Sheraz R Markar, Daniel Jackson,  Amyn Haji, Omar Faiz.Colorectal Disease 2013 Epub ahead of print

Aim With an increasing array of treatment modalities available for colon cancer, it is increasingly important to stage tumours accurately to allocate appropriate management. The study evaluated the accuracy of mini-probe endoscopic ultrasound (EUS) in assigning clinical stage to colon cancer.

 Method An electronic search was performed in January 2013 using the Embase Medline and Cochrane databases. It was supplemented by a hand search of published abstracts from scientific meetings.Trials evaluating the accuracy of the mini-probe EUS compared to histopathological grade in determining clinical stage of colonic cancer were included in this pooled analysis. The main outcome measures included accuracy, sensitivity and specificity for T and N staging.

Results Ten studies were identified which compared the mini-probe EUS staging of 642 colon or rectal cancer to the histopathological specimen. The pooled sensitivity and specificity for staging were 0·91 and 0·98 for T1 tumours, 0·78 and 0·94 for T2 tumours, 0·97 and 0·90 for T3/T4 tumours; and 0·63 and 0·82 for nodal staging. Eight percent of T1/T2 tumours were upstaged to T3/T4 tumours and 5% of T3/T4 tumours were downstaged.

Conclusion Mini-probe EUS is highly effective to assign clinical stage in colonic cancer and in identifying patients who may be suitable for non-surgical treatment including neoadjuvant chemotherapy or endoscopic resection.






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