The impact of endoscopic ultrasound on the management and outcome of patients with oesophageal cancer: an update of a systematic review
The impact of endoscopic ultrasound on the management and outcome of patients with oesophageal cancer: an update of a systematic review
AIM: To provide an updated systematic review concerning the impact of endoscopic ultrasound (EUS) in the modern era of oesophageal cancer staging.
MATERIALS AND METHODS: To update the previous systematic review, databases including MEDLINE and EMBASE were searched and studies published from 2005 onwards were selected. Studies reporting primary data in patients with oesophageal or gastro-oesophageal junction cancer who underwent radiological staging and treatment, regardless of intent, were included. The primary outcome was the reported change in management after EUS. Secondary outcomes were recurrence rate and overall survival. Two reviewers extracted data from included articles. This study was registered with PROSPERO (CRD42021231852).
RESULTS: Eighteen studies with 11,836 patients were included comprising 2,805 patients (23.7%) who underwent EUS compared to 9,031 (76.3%) without EUS examination. Reported change of management varied widely from 0% to 56%. When used, EUS fine-needle aspiration precluded curative treatment in 37.5%–71.4%. Overall survival improvements ranged between 121 and 639 days following EUS intervention compared to patients without EUS. Smaller effect sizes were observed in a randomised controlled trial, compared to larger differences reported in observational studies.
CONCLUSION: Current evidence for the effectiveness of EUS in oesophageal cancer pathways is conflicting and of limited quality. In particular, the extent to which EUS adds value to contemporary cross-sectional imaging techniques is unclear and requires formal re-evaluation.
e346-e355
Foley, K. G.
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Franklin, J.
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Jones, C. M.
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Coles, B.
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Roberts, S. A.
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Underwood, T. J.
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Crosby, T.
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5 April 2022
Foley, K. G.
d9d17bd6-415a-48b2-ab23-6cc819e34368
Franklin, J.
da671076-2c4c-47b6-82a1-992e5a77ed64
Jones, C. M.
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Coles, B.
777544e8-413d-48a4-99d6-346147a30484
Roberts, S. A.
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Underwood, T. J.
8e81bf60-edd2-4b0e-8324-3068c95ea1c6
Crosby, T.
82fd6364-ad6d-4e24-bb81-e1868258c4e6
Foley, K. G., Franklin, J., Jones, C. M., Coles, B., Roberts, S. A., Underwood, T. J. and Crosby, T.
(2022)
The impact of endoscopic ultrasound on the management and outcome of patients with oesophageal cancer: an update of a systematic review.
Clinical Radiology, 77 (5), .
(doi:10.1016/j.crad.2022.02.001).
Abstract
AIM: To provide an updated systematic review concerning the impact of endoscopic ultrasound (EUS) in the modern era of oesophageal cancer staging.
MATERIALS AND METHODS: To update the previous systematic review, databases including MEDLINE and EMBASE were searched and studies published from 2005 onwards were selected. Studies reporting primary data in patients with oesophageal or gastro-oesophageal junction cancer who underwent radiological staging and treatment, regardless of intent, were included. The primary outcome was the reported change in management after EUS. Secondary outcomes were recurrence rate and overall survival. Two reviewers extracted data from included articles. This study was registered with PROSPERO (CRD42021231852).
RESULTS: Eighteen studies with 11,836 patients were included comprising 2,805 patients (23.7%) who underwent EUS compared to 9,031 (76.3%) without EUS examination. Reported change of management varied widely from 0% to 56%. When used, EUS fine-needle aspiration precluded curative treatment in 37.5%–71.4%. Overall survival improvements ranged between 121 and 639 days following EUS intervention compared to patients without EUS. Smaller effect sizes were observed in a randomised controlled trial, compared to larger differences reported in observational studies.
CONCLUSION: Current evidence for the effectiveness of EUS in oesophageal cancer pathways is conflicting and of limited quality. In particular, the extent to which EUS adds value to contemporary cross-sectional imaging techniques is unclear and requires formal re-evaluation.
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Accepted/In Press date: 1 February 2022
e-pub ahead of print date: 11 March 2022
Published date: 5 April 2022
Additional Information:
Funding Information:
The authors acknowledge Mrs Anne Cleves who retrieved all articles reviewed during this study. No direct funding was obtained for this systematic review. K.F. was supported by the Moondance Foundation at Velindre Cancer Centre and Health and Care Research Wales (HCRW). C.M.J. was supported for the duration of this work by a Wellcome Trust Clinical Research Fellowship. T.J.U. is the Royal College of Surgeons of England Surgical Specialty Lead for Oesophageal cancer and supported by the Association of Upper Gastrointestinal Surgery (AUGIS) of Great Britain and Ireland, and Heartburn Cancer UK.
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© 2022
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Copyright 2022 Elsevier B.V., All rights reserved.
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Local EPrints ID: 457249
URI: http://eprints.soton.ac.uk/id/eprint/457249
ISSN: 0009-9260
PURE UUID: 71cfe0bc-c3cd-41bd-9684-63e9ba562943
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Date deposited: 27 May 2022 16:50
Last modified: 18 Mar 2024 05:29
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Author:
K. G. Foley
Author:
J. Franklin
Author:
C. M. Jones
Author:
B. Coles
Author:
S. A. Roberts
Author:
T. Crosby
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