G. De Manzoni et al., Intraoperative US staging of T in gastric cancer: Final results of a blindprospective study, J SURG ONC, 78(3), 2001, pp. 158-161
Background: In order to improve the accuracy in the assessment of depth of
tumor invasion, we performed an ultrasound examination of the resected spec
imen intraoperatively just after removal by the surgeon (Intraoperative Ult
rasonography (IUS). This prospective blind study reports the results obtain
ed with the IUS in the staging of T in a group of 281 patients who underwen
t curative gastrectomy for gastric cancer.
Methods: After the removal by the surgeon, the portion of the stomach harbo
ring the tumor was submitted to ultrasonography with a linear 7.5 Mhz probe
. An echo-free standoff pad was placed between the probe and the organ; a s
econd echo-free standoff pad was interposed between the stomach and the sup
port surface. The diagnosis of depth of invasion was based on the degree of
disruption of the five-layer sonographic structure of the gastric wall.
Results: The IUS staging of T corresponded to the pathological diagnosis in
256 out of 281 cases (overall accuracy 91.1%). The sensitivity in the diff
erent classes of T was, respectively, 91.2 in T1m cases, 83.3 in the T1sm c
ases, 89.6 in the T2 cases, and 93.5% in the T3 cases.
Conclusion: The IUS on the resected specimen has a high degree of accuracy
in the assessment of depth of tumor invasion and seems to be an important a
dvance in the clinical staging of gastric cancer. (C) 2001 Wiley-Liss, Inc.