Accuracy of endoscopic ultrasonography for determining the treatment method for early gastric cancer.

Background. Endoscopic resection (ER) for early gastric cancer (EGC) is a minimally invasive and curative treatment. The value of endoscopic ultrasonography (EUS) in determining the therapeutic strategy for EGC was assessed in this study. Materials and Methods. Pretreatment EUS was performed on 406 EGCs. The lesions were divided into the histological categories m/sm1 and sm2. The EUS-determined depths of invasion were classified as EUS-M/SM1, EUS-SM2, and EUS-MP or deeper. An analysis of the factors influencing the EUS-based depth determination was then conducted. Results. Most (92.8%) of the EUS-M/SM1 group belonged to the m/sm1 histological category. Ulcerated lesions, tumor size of larger than 2 cm, and the use of an ultrasound endoscope were independently associated with misdiagnosis of the depth of EGC by EUS. The ulcerated lesions had a significantly higher probability of overestimation. Conclusions. EUS is a useful method for determining the therapeutic strategy for EGC. Special attention should be paid not to overestimate the depth of cancer invasion when determining the ulcerated lesions and the type of curative procedure to be used.