Impact of lymph node staging on therapy of XXXX .

@entity1 @entity5 @entity418
BACKGROUND _ AIMS: Therapy of @entity418 is stage dependent. The role of EUS-guided fine-needle aspiration (EUS FNA) in this setting is unclear. The aims of this study were to compare the performance characteristics of CT, EUS, and EUS FNA for preoperative nodal staging of @entity418 and to measure the impact of each staging test on treatment decisions. METHODS: From December 1999 to March 2001, all @entity1 with @entity418 seen at the Mayo Clinic Rochester were prospectively evaluated with CT, EUS, and EUS FNA. The impact of @entity5 stage on final therapy was assessed. RESULTS: A total of 125 @entity1 with @entity418 were enrolled. 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 @entity1 evaluated due to advanced locoregional/metastatic disease. @entity5 location, @entity1 age, comorbidities, and @entity5 stage determined by CT, EUS, and EUS FNA were associated with treatment decisions (P < 0.05). EUS FNA resulting in a higher/worse stage than CT (41 @entity1 ) was associated with a greater rate of treatments that were not direct surgeries compared with cases in which the stage was the same or better. CONCLUSIONS: EUS FNA is more accurate for nodal staging and impacts on therapy of @entity1 with @entity418 . EUS FNA should be included in the preoperative staging algorithm of these @entity1 .
