Critical appraisal:Cen P, Hofstetter WL, Lee JH, Ross WA, Wu TT, Swisher SG, et al 2008

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Critical Appraisal

Article being appraised

Cen P, Hofstetter WL, Lee JH, Ross WA, Wu TT, Swisher SG, et al. Value of endoscopic ultrasound staging in conjunction with the evaluation of lymphovascular invasion in identifying low-risk esophageal carcinoma. Cancer 2008 Feb 1;112(3):503-10 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18072264.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

87


Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: Please replace this text and include any additional comments in regards to your quality rating

Risk of bias assessment: case series

Subject selection:
Highly selected or not described (e.g. single-institution study)
Were the outcome measures blind to pre/post-intervention?
No, but objective measures used
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Size of effect
5 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
3 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

Jutta's exclamation mark icon.png Excluded

Reason for decision

Excluded study population was not exclusively patients with adenocarcinoma (i.e. some patients in study had SCC).

Comments

This is a retrospective single-institution case series of 87 consecutive patients who had pretreatment EUS and underwent oesophagectomy (81 adenocarcinoma, 6 SCC). EUS correctly diagnosed 59 T1 cancers and 20 T2-4 cancers but understaged cancers in 2 patients and overstaged cancers in 6 patients. The accuracy, sensitivity, and specificity of EUS for
T1 cancers were 91%, 91%, and 91%, respectively; for T1a (intramucosal) cancers, the accuracy, sensitivity, and specificity were: 82%, 67%, and 93%, respectively, and for lymph node involvement these same values were 81%, 38%, and 94%, respectively.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


Jutta's tick icon.png This appraisal has been completed.


Article
Cen P, Hofstetter WL, Lee JH, Ross WA, Wu TT, Swisher SG, et al. Value of endoscopic ultrasound staging in conjunction with the evaluation of lymphovascular invasion in identifying low-risk esophageal carcinoma. Cancer 2008 Feb 1;112(3):503-10 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18072264.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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