Puli SR et al. - Endoscopic ultrasound (EUS) results are more accurate with advanced disease than early disease. If EUS diagnoses advanced disease, such as T4 disease, the patient is 500 times more likely to have true anatomic stage of T4 disease. Methods
Study to evaluate the accuracy of EUS for staging of gastric cancers
Only EUS studies confirmed by surgery were selected
Only studies from which a 2 multiply 2 table could be constructed for true positive, false negative, false positive and true negative values were included
Two reviewers independently searched and extracted data
The differences were resolved by mutual agreement
2 multiply 2 tables were constructed with the data extracted from each study
Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratio
Results
376/1620 relevant articles were selected and reviewed
22 studies (n=1896) which met the inclusion criteria were included in this analysis
Pooled sensitivity of T1 was 88.1% and T2 was 82.3%
For T3, pooled sensitivity was 89.7%
T4 had a pooled sensitivity of 99.2%
For nodal staging, the pooled sensitivity for N1 was 58.2% and N2 was 64.9%
Pooled sensitivity to diagnose distant metastasis was 73.2%
The P for chi-squared heterogeneity for all the pooled accuracy estimates was >0.10
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