The increased complexity of the 7th/8th edition T staging system is accompanied by worsening of the predictive accuracy for EUS as compared to the 6th edition. We also found that irregularities in the outer edge of the gastric wall were markers of gastric serosal layer penetration with a positive predictive value of 92.2%. We further analyzed the EUS image features for each tumor T stage and found that an indistinctly visible muscularis propria (MP) or with obvious thickening was considered an indicator of lesions involved in the MP with a sensitivity of 81.3% an MP completely disappeared and accompanied with a serosal layer intact may be a marker that the lesion invaded to the subserosa. The tumor location, echoendoscope type, and histological type were associated with inaccuracy. T3 stage accuracy was significantly worse when the T3 group status was changed. The accuracy of EUS T staging was 72.4% for the 7th/8th edition and 78.4% for the 6th edition. Differences between the 6th and 7th/8th edition T staging systems for preoperative EUS evaluation were compared.

MethodsĪ retrospective analysis of clinical and EUS imaging features of 348 gastric carcinoma patients who underwent radical resection were retrospectively analyzed. The aim of this study was to evaluate the superiority of EUS by using the 6th edition American Joint Committee on Cancer (AJCC) staging system for stomach cancer compared to the new 7th/8th edition. The efficacy of endoscopic ultrasound (EUS) for determining the T category of gastric cancer is variable.

Ajcc cancer staging