Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2018; 10(1): 37-44
Published online Jan 16, 2018. doi: 10.4253/wjge.v10.i1.37
Mediastinal node staging by positron emission tomography-computed tomography and selective endoscopic ultrasound with fine needle aspiration for patients with upper gastrointestinal cancer: Results from a regional centre
Chris Harrington, Lyn Smith, Jennifer Bisland, Elisabet López González, Neil Jamieson, Stuart Paterson, Adrian John Stanley
Chris Harrington, Lyn Smith, Jennifer Bisland, Elisabet López González, Neil Jamieson, Stuart Paterson, Adrian John Stanley, Glasgow Royal Infirmary, Glasgow G4 0ET, United Kingdom
Chris Harrington, Stuart Paterson, Forth Valley Royal Hospital, Larbert FK5 4WR, United Kingdom
Elisabet López González, Hospital Vega Baja, Orihuela 03314, Spain
Neil Jamieson, Raigmore Hospital, Inverness IV2 3UJ, United Kingdom
Author contributions: Paterson S and Stanley AJ conceived this manuscript; Smith L, Bisland J, López González E and Harrington C collected data; Harrington C wrote the paper, with input from all co-authors who approved the final submission.
Institutional review board statement: After discussion with the local Ethics Service, they considered this retrospective project to be an audit rather than a research project, therefore ethical approval was not required.
Informed consent statement: As this retrospective study was accepted to be an audit project, with anonymised data and no intervention for any patient, informed consent from patients was not required.
Conflict-of-interest statement: There are no conflicts of interest for any of the authors.
Data sharing statement: The raw data is available from Harrington C at chrisharrington@nhs.net. Consent has not been obtained for sharing of this data but all data have been anonymised and the risk of identification is therefore low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Adrian John Stanley, BM BCh, FRCP (C), MD, Associate Professor, Consultant Gastroenterologist, Glasgow Royal Infirmary, Walton Building, Castle Street, Glasgow G4 0ET, United Kingdom. adrian.stanley@ggc.scot.nhs.uk
Telephone: +44-141-2114073
Received: July 26, 2017
Peer-review started: July 28, 2017
First decision: September 11, 2017
Revised: November 4, 2017
Accepted: November 19, 2017
Article in press: November 20, 2017
Published online: January 16, 2018
Processing time: 172 Days and 10.7 Hours
Core Tip

Core tip: We have found that positron emission tomography-computed tomography (PET-CT) in the setting of upper gastrointestinal cancer has a high sensitivity and negative predictive value, but has poor specificity and positive predictive value for the detection of malignant mediastinal lymph nodes. This could lead to many patients being over-staged by PET-CT alone. The use of endoscopic ultrasound-guided fine-needle aspiration of mediastinal nodes results in more patients being offered radical therapy.