Critical appraisal:Vazquez-Sequeiros E, Wiersema MJ, Clain JE, Norton ID, Levy MJ, Romero Y, et al 2003

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Critical Appraisal

Article being appraised

Vazquez-Sequeiros E, Wiersema MJ, Clain JE, Norton ID, Levy MJ, Romero Y, et al. Impact of lymph node staging on therapy of esophageal carcinoma. Gastroenterology 2003 Dec;125(6):1626-35 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/14724814.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

125


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
2 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-centre case series of 125 patients with oesophageal carcinoma who underwent CT, EUS, and EUS FNA during preoperative nodal staging. EUS FNA was more sensitive (83% vs. 29%;P<0.001) than CT and more accurate than CT (87% vs. 51%;P<0.001) or EUS (87% vs. 74%;P=0.012) for nodal staging. Direct surgical resection was contraindicated in 77% of patients evaluated due to advanced locoregional/metastatic disease. Tumour location, patient age, comorbidities, and tumour stage determined by CT, EUS, and EUS FNA were associated with treatment decisions (P<0.05). The authors concluded that EUS FNA is more accurate for nodal staging and impacts on therapy of patients with oesophageal carcinoma.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


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Article
Vazquez-Sequeiros E, Wiersema MJ, Clain JE, Norton ID, Levy MJ, Romero Y, et al. Impact of lymph node staging on therapy of esophageal carcinoma. Gastroenterology 2003 Dec;125(6):1626-35 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/14724814.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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