Critical appraisal:Pech O, May A, Günter E, Gossner L, Ell C 2006

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Critical Appraisal

Article being appraised

Pech O, May A, Günter E, Gossner L, Ell C. The impact of endoscopic ultrasound and computed tomography on the TNM staging of early cancer in Barrett's esophagus. Am J Gastroenterol 2006 Oct;101(10):2223-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/17032186.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

100


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 tick icon.png Included



Comments

This is a prospective, single institution case series of 100 consecutive patients with suspected early adenocarcinoma in Barrett's oesophagus who underwent staging with endoscopy, EUS, CT chest and upper abdomen and abdominal US.
The median follow-up period was 25 months (IQR 19.5–30.0). The T category diagnosed with CT was ≤T1 in all patients. On EUS, the T category was classified as T1 in 92% of cases and as >T1 in 8%. Sensitivity of CT for N staging was not acceptable compared with EUS (38% vs 75%). The authors concluded that in suspected early cancer in Barrett’s esophagus, EUS is superior to CT for T staging and N staging.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


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


Article
Pech O, May A, Günter E, Gossner L, Ell C. The impact of endoscopic ultrasound and computed tomography on the TNM staging of early cancer in Barrett's esophagus. Am J Gastroenterol 2006 Oct;101(10):2223-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/17032186.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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