scholarly journals Impact of lymphovascular invasion in bladder cancer ~Comparison of transurethral resection and total cystectomy: a retrospective cohort study

2020 ◽  
Author(s):  
Kei Yoneda ◽  
Naoto Kamiya ◽  
Takanobu Utsumi ◽  
Ken Wakai ◽  
Ryo Oka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Transurethral Resection ◽  
Medical Records ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Urinary Cytology ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Positive Results

Abstract Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. Methods: We reviewed 216 patients who underwent first TURBT and 64 patients who underwent RC at our hospital. Medical records were reviewed uniformly, collecting the following data: age, sex, clinical and pathological T stage, neoadjuvant chemotherapy, grade, metastasis, urinary cytology, carcinoma in situ and LVI. Results: LVI was identified in 22.7% of patients who underwent first TURBT, and 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p=0.009) and LVI at first TURBT (HR 9.205, p=0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, inclusion of G3 and LVI were significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p<0.05). Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.

scholarly journals Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 244
Author(s):  
Kei Yoneda ◽  
Naoto Kamiya ◽  
Takanobu Utsumi ◽  
Ken Wakai ◽  
Ryo Oka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Radical Cystectomy ◽  
Transurethral Resection ◽  
Lymphovascular Invasion ◽  
Medical Center ◽  
Univariate Analysis ◽  
The Other ◽  
Significant Prognostic Factor ◽  
Cancer Specific Survival ◽  
Positive Results

(1) Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. (2) Methods: We analyzed 216 patients who underwent first TURBT and 64 patients who underwent RC at Toho University Sakura Medical Center. (3) Results: LVI was identified in 22.7% of patients who underwent first TURBT, and in 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p = 0.009) and LVI at first TURBT (HR 9.205, p = 0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, presence of G3 and LVI was significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p < 0.05). (4) Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.

scholarly journals Preoperative Clinical Predictors of Lymphovascular Invasion of Bladder Tumors at Transurethral Resection Pathology

2020 ◽  
Vol 14 (3) ◽  
pp. 135-141
Author(s):  
Kei Yoneda ◽  
Takanobu Utsumi ◽  
Ken Wakai ◽  
Ryo Oka ◽  
Takumi Endo ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Lymphovascular Invasion ◽  
Medical Center ◽  
Preoperative Evaluation ◽  
Univariate Analysis ◽  
Urinary Cytology ◽  
High Grade ◽  
Clinical Predictors ◽  
Bladder Tumors

<b><i>Background</i></b>: The assessment of lymphovascular invasion (LVI) on the specimens of a transurethral resection of bladder tumors (TURBT) is very important for risk stratification and decision-making on further treatment for bladder cancer. <b><i>Objectives</i></b>: The present study aimed to identify clinical predictors associated with the risk of bladder cancer with LVI before a first TURBT. <b><i>Methods</i></b>: A total of 291 patients underwent a first TURBT for bladder cancer at Toho University Sakura Medical Center between January 2012 and December 2016. We analyzed predictors of LVI based on data from 217 patients and predictors of high grade and ≥ pT1 tumors based on data from the medical records of 237 patients for comparison with LVI risk factors. <b><i>Results</i></b>: Univariate analysis significantly associated LVI with episodes of gross hematuria, positive urinary cytology, and larger, non-papillary and sessile tumors. Multivariate analysis selected larger tumors [odds ratio (OR) 1.39; 95 % confidence interval (CI) 1.08-1.78; p = 0.01], and non-papillary (OR 10.05; 95% CI 3.75-26.91; p < 0.01) and sessile (OR 2.65; 95% CI 1.18-5.93; p = 0.02) tumors as significant predictors of LVI. Some predictors such as tumor size and non-papillary tumors overlapped between high-grade and ≥ pT1 bladder cancer. <b><i>Conclusions</i></b>: These predictors can help clinicians to identify patients with, or who are at high-risk for LVI before undergoing a first TURBT and to determine priorities for preoperative evaluation and scheduling consecutive treatments.

Regression Does Not Predict Nodal Metastasis or Survival in Patients with Cutaneous Melanoma

2011 ◽  
Vol 77 (8) ◽  
pp. 1009-1013 ◽  
Author(s):  
Alison L. Burton ◽  
Juliana Gilbert ◽  
Russell W. Farmer ◽  
Arnold J. Stromberg ◽  
Lee Hagendoorn ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cutaneous Melanoma ◽  
Clinical Decision Making ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Nodal Metastasis ◽  
Breslow Thickness ◽  
Significant Prognostic Factor ◽  
Superficial Spreading ◽  
Histologic Subtype

Controversy exists regarding the prognostic implications of regression in patients with cutaneous melanoma. Some consider regression to be an indication for sentinel lymph node (SLN) biopsy because regression may result in underestimation of the true Breslow thickness. Other data support regression as a favorable prognostic indicator, representing immune system recognition of the primary tumor. This analysis was performed to determine whether regression predicts nodal metastasis, disease-free survival (DFS), or overall survival (OS). Post hoc analysis was performed of a multicenter prospective randomized trial that included patients aged 18 to 70 years with cutaneous melanomas 1 mm or greater Breslow thickness. All patients underwent SLN biopsy; those with tumor-positive SLN underwent completion lymphadenectomy. Kaplan-Meier analysis of survival, univariate analysis, and multivariate analysis were performed. A total of 2220 patients (261 with regression; 1959 without regression) were included in this analysis with a median follow-up of 68 months. Patients with regression were more likely to be male, older than 50 years old, and have lower median Breslow thickness, superficial spreading histologic subtype, and a non-extremity anatomic location ( P < 0.05 in all cases). Regression was not significantly associated with Clark level, ulceration, lymphovascular invasion, number of SLNs removed, or SLN metastasis. On multivariate analysis, factors independently predictive of DFS included Breslow thickness, ulceration, and SLN status ( P < 0.05 in all cases); the same factors along with age, gender, and anatomic tumor location were significantly associated with OS ( P < 0.05 in all cases). Regression was not significantly associated with DFS (risk ratio [RR], 0.94; 95% confidence interval [CI], 0.67-1.27; P = 0.68) or OS (RR, 1.01; 95% CI, 0.76-1.32; P = 0.93). These data suggest that regression is not a significant prognostic factor for patients with cutaneous melanoma and should not be used to guide clinical decision-making for such patients.

DOES T STAGE AFFECT PROGNOSIS IN PATIENTS WITH STAGE IV B DIFFERENTIATED THYROID CANCER?

2019 ◽  
Vol 25 (9) ◽  
pp. 877-886 ◽  
Author(s):  
Mu Li ◽  
Nitin Trivedi ◽  
Chenyang Dai ◽  
Rui Mao ◽  
Yuning Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Papillary Thyroid ◽  
Follicular Thyroid Cancer ◽  
Cancer Specific Survival ◽  
T Stage

Objective: Differentiated thyroid cancer (DTC), the most common subtype of thyroid cancer, has a relatively good prognosis. The 8th edition of the American Joint Committee on Cancer (AJCC) pathologic tumor-node-metastasis (T [primary tumor size], N [regional lymph nodes], M [distant metastasis]) staging system did not take the T stage into consideration in stage IV B DTC patients. We evaluated the prognostic value of the T stage for advanced DTC survival. Methods: DTC cases that were considered stage IV B in the AJCC 8th edition were extracted from the Surveillance, Epidemiology, and End Results database. T stage (AJCC 6th standard) was categorized into T0–2, T3 and T4. We analyzed overall survival (OS) and cancer specific survival (CSS) in the overall group as well as in pathologic subgroups. We used the Kaplan-Meier method and log-rank test for univariate analysis and the Cox regression model for multivariate analysis. Results: A total of 519 cases were extracted. Patients with earlier T stages showed significantly better OS and CSS in univariate analysis. T stage was an independent prognostic factor for both OS and CSS in multivariate analysis. Subgroup analysis in papillary and follicular thyroid cancer showed that T4 was an independent prognostic factor for both OS and CSS. Conclusion: AJCC 8 stage IV B DTC patients could be further stratified by T stage. Further studies with larger samples and AJCC 8 T stage information are necessary. Abbreviations: AJCC = American Joint Committee on Cancer; CI = confidence interval; CSS = cancer specific survival; DTC = differentiated thyroid cancer; FTC = follicular thyroid cancer; FVPTC = follicular variant of papillary thyroid carcinoma; HR = hazard ratio; OS = overall survival; PTC = papillary thyroid cancer; SEER = surveillance, epidemiology, and end results database

Prognostic factors in uterine sarcoma: A clinicopathologic and immunohistochemical (IHC) study of 30 cases

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 16071-16071
Author(s):  
F. Al-Safi ◽  
A. Al Kushi ◽  
S. Ameeri ◽  
N. Al Merri
Keyword(s):  
Patient Outcome ◽  
Multivariate Analysis ◽  
Tumor Cell ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Uterine Sarcoma ◽  
Low Grade ◽  
Cell Type ◽  
Survival Curves ◽  
P53 Expression

16071 Background: The objective of this study is to examine the prognostic relevance of traditional clinical, pathological and IHC features of uterine sarcoma (US). Methods: The study population consisted of thirty cases of US treated at our institute. Twenty- two cases are HGS (11 leiomyosarcoma, and 11 carcinosarcoma) and eight cases are LGS (5 mullerian adenosarcoma and 3 low grade endometrial stromal sarcoma). Clinical and pathological data including patient's age, parity, menopausal status, tumor cell type, lymphovascular invasion, nuclear grade, stage and mitotic index. Serial sections were immunostained with antibodies for p53, bcl-2, estrogen receptor (ER), Her2 and c-kit. The clinicopathological and IHC features were analysed by using Kaplan-Meier method for constructing survival curves, and log-rank statistic for survival curves comparison. Multivariate analysis was performed using Cox regression modeling. Results: The mean follow-up period of patients is 32 months (range 1- 120). Twelve (55%) patients with HGS died of the disease and none of the LGS group. In the HGS group, stage (p=0.01), myometrial invasion in early stage tumor (p=0.04), and lymphovascular invasion (p=0.043) were significant predicators of patient outcome in univariate analysis. Similarly, tumor cell type, ER, p53 and bcl-2 expression showed statistical significant correlation with tumor-specific survival (p=0.0039, p=0.001, p=0.03, and p=0.04, respectively). ER and bcl-2 expression were associated with better outcome and the opposite for p53 expression. In a multivariate analysis, only the tumor stage and cell type had independent statistical significance (p=0.04, and p=0.035, respectively). Overexpression of p53 and Her2 were observed in 40% and 60% of carcinosracomas respectively and not seen in any of the other tumors. The c-kit immunostain showed focal and weak staining in 40% of carcinosarcoma and only in 33% of leiomyosarcoma. None of LGS had this marker. The ER was expressed only in the LGS group. Conclusions: This study demonstrates that stage and tumor cell type are the most important prognostic indicators of patient outcome in US. IHC markers such as ER, p53, c-kit, and Her2 can be useful ancillary tools to discriminate between HGS and LGS in difficult cases. No significant financial relationships to disclose.

scholarly journals Microbiologically and Clinically Diagnosed Vertebral Osteomyelitis: Impact of Prior Antibiotic Exposure

2012 ◽  
Vol 56 (4) ◽  
pp. 2122-2124 ◽  
Author(s):  
Chung-Jong Kim ◽  
Kyoung-Ho Song ◽  
Wan Beom Park ◽  
Eu Suk Kim ◽  
Sang Won Park ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Medical Records ◽  
Vertebral Osteomyelitis ◽  
Antibiotic Exposure ◽  
Negative Results ◽  
Paravertebral Abscess ◽  
Pyogenic Vertebral Osteomyelitis ◽  
Positive Results

ABSTRACTWe retrospectively reviewed medical records to identify the factors that affect the results of culture in patients with pyogenic vertebral osteomyelitis. In multivariate analysis, the presence of paravertebral abscess was associated with positive results of microbiologic culture. Prior antibiotic exposure, especially of longer duration, was strongly associated with negative results.

scholarly journals The Prognostic Value of Pre-treatment Hemoglobin (Hb) in Patients With Advanced or Metastatic Gastric Cancer Treated With Immunotherapy

2021 ◽  
Vol 11 ◽  
Author(s):  
Miaomiao Gou ◽  
Yong Zhang ◽  
Tiee Liu ◽  
Tongtong Qu ◽  
Haiyan Si ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Prognostic Value ◽  
Univariate Analysis ◽  
Objective Response ◽  
Progression Free Survival ◽  
Metastatic Gastric Cancer ◽  
Significant Prognostic Factor ◽  
Angiogenic Therapy ◽  
Pre Treatment

BackgroundBiomarkers such as prevailing PD-L1 expression and TMB have been proposed as a way of predicting the outcome of immunotherapy in patients with advanced gastric cancer (AGC) and metastatic gastric cancer (MGC). Our study aims to investigate whether there is a link between pretreatment hemoglobin (Hb) levels and survival to immunotherapy in patients with AGC and MGC.MethodsWe retrospectively reviewed patients with AGC or MGC treated at the oncology department of the Chinese PLA general hospital receiving PD-1 inhibitor. The Propensity Score Matching (PSM) (1:1) was performed to balance potential baseline confounding factors. Progression-free survival (PFS) and overall survival (OS) was analyzed among different Hb level (normal Hb group and decreased Hb group). Objective response rate (ORR), disease control rate (DCR) were also analyzed. Univariate analysis and multivariate analysis were performed further to validate the prognostic value of Hb level.ResultsWe included 137 patients with AGC and MGC who received PD-1 inhibitors (including Pembrolizumab, Nivolumab, Sintilimab, Toripalimab) in this study. After PSM matching, there were no significant differences between the two groups for baseline characteristics. Within the matched cohort, the median PFS was 7.8 months in the normal Hb level group and 4.3 months in the decreased Hb group (HR 95% CI 0.5(0.31, 0.81), P=0.004). The OS was 14.4 months with normal Hb level as compared with 8.2 months with decreased Hb level(HR 95% CI 0.59(0.37, 0.94), P=0.024). The ORR was 40.7% and DCR was 83.0% in the normal Hb group, while the ORR was 25.5% and DCR was 85.1% in the decreased Hb group. No significant differences were found in the ORR and DCR between the two groups (P=0.127, P=0.779). Univariate analysis and multivariate analysis showed that Hb level was only independent predictor for PFS and baseline Hb level was significant prognostic factor influencing the OS. Only when patients had normal Hb level, anti-pd-1 monotherapy or combined with chemotherapy was superior to anti-pd-1 plus anti-angiogenic therapy with respect to PFS (10.3 m vs 2.8 m, HR 95% CI 0.37(0.15, 0.95), P=0.031) and OS(15 m vs 5.7 m, HR 95% CI 0.21 (0.08, 0.58), P=0.001).ConclusionsOur study have demonstrated that pretreatment Hb level was an independent prognostic biomarker in term of PFS and OS with immunotherapy for AGC and MGC patients. Correction of anemia for GC patients as immunotherapy would be a strategy to improve the survival. More data was warranted to further influence this finding.

Can serum cytokeratin 19 fragments predict postoperative early progression in patients with upper urinary tract urothelial carcinoma?

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 557-557
Author(s):  
Yuki Endo ◽  
Go Kimura ◽  
Naoto Hodotsuka ◽  
Hiroya Hasegawa ◽  
Shigehito Minaguchi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Adjuvant Chemotherapy ◽  
Urothelial Carcinoma ◽  
Univariate Analysis ◽  
Positive Margin ◽  
Rank Test ◽  
Cytokeratin 19 ◽  
High Group ◽  
Cancer Specific Survival ◽  
Early Progression

557 Background: Current guidelines do not yet provide recommendations for any serum tumor markers in patients with upper tract urothelial carcinoma (UTUC) who received nephroureterectomy (NU). The criteria for adjuvant chemotherapy is also controversial. Previous studies have shown that serum cytokeratin levels (sCK) were correlated with depth of tumor invasion and metastases in patients with bladder cancer. We found that preoperative sCK was correlated with cancer specific survival(CSS) after NU. In this study we evaluated whether postoperative sCK (poCK) could predict early progression in patients who received NU. Methods: 160 patients with UTUC underwent NU from December 2003 to 2014 at our institution. The median age at diagnosis was 73 years (41-89). poCK19 had been measured in 112 patients within 8 weeks after NU. Patients were divided into two groups, a high-group and a low-group based on poCK19 levels (a cut-off value of 3.5 ng/mL). CSS and progression-free survival (PFS) were measured by Kaplan–Meier curves and log–rank test. Multivariate analysis was carried out using the Cox hazards model. Results: Of 112 patients ≤pT1 was 39 (34%), pT2 in 26 (23%), pT3 in 40 (35%), and pT4 in 7 (8%). The 5-year (5y) CSS rate was 86% and the 5yPFS rate was 60%. There were 24 (21%) patients in the high-group and 88 (79%) in the low-group. During the median follow-up period of 34.0 (1-152) months, 39 patients (35%) died. The 5yCSS rate of the high-group was 51%, which is significantly lower than the low-group (86%) (p<0.001). The 1yPFS of the high-group was 66%, which was significantly lower than that of the low-group (86%) (p<0.001). On univariate analysis, positive margin (HR4.0, p<0.001) and poCK19 (HR3.9, p<0.001) were the significant factors for 1yPFS. On multivariate analysis, poCK19 (HR5.3 95%CI (1.8-15.7), p=0.002) and positive margin (HR 4.6 95%CI (1.1-18.9), p=0.032) were also independent factors for 1yPFS. Conclusions: Our study suggests that postoperative sCK19 could predict early progression in patients with UTUC who received NU. Adjuvant chemotherapy might be indicated for patients with high postoperative sCK19 levels independent of pathological findings.

Visceral Pleural Invasion Is a Significant Prognostic Factor in Patients with Partly Solid Lung Adenocarcinoma Sized 30 mm or Smaller

2016 ◽  
Vol 66 (02) ◽  
pp. 150-155 ◽  
Author(s):  
Yangki Seok ◽  
Eungbae Lee
Keyword(s):  
Computed Tomography ◽  
Multivariate Analysis ◽  
Lung Adenocarcinoma ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Pulmonary Adenocarcinoma ◽  
Significant Prognostic Factor ◽  
Pleural Invasion ◽  
Visceral Pleural Invasion ◽  
The Impact

Background This study analyzed the impact of visceral pleural invasion (VPI) on the disease-free survival (DFS) of patients with partly solid pulmonary adenocarcinoma sized 30 mm or smaller. Method This is a retrospective study of 147 patients with surgically resected pathologic N0 pulmonary adenocarcinoma that had a partly solid appearance on preoperative computed tomography. All patients presented with tumors of size 30 mm or smaller. The DFS rate was estimated using Kaplan–Meier method. A multivariate analysis for prognostic factors was performed using the Cox proportional hazards regression model. Results VPI was found in 36 patients. The 5-year DFS in 111 patients without VPI (97.6%) was significantly higher than that in 36 patients with VPI (63%) (p < 0.0001). Univariate analysis revealed three significant poor prognostic predictors: the presence of VPI, the presence of lymphovascular invasion, and the size of the solid component on computed tomography (>20, ≤30 mm). According to the multivariate analysis, VPI was found to be a significant poor prognostic predictor (hazard ratio for DFS = 7.31, 95% confidence interval = 1.444–37.014, p = 0.016). Conclusion VPI is a significant predictor of poor prognosis for small-sized (≤30 mm) partly solid lung adenocarcinoma. Therefore, upstaging of the T factor from T1 to T2 on the basis of VPI as described by the TNM staging system is mandatory regardless of ground-glass opacity in small lung adenocarcinoma.

Preoperative accuracy of gastric cancer staging in patient selection for neoadjuvant therapy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 34-34
Author(s):  
Naruhiko Ikoma ◽  
Elena Elimova ◽  
Mariela A. Blum ◽  
Jaffer A. Ajani ◽  
Y. Sabrina Chiang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Multivariate Analysis ◽  
Neoadjuvant Therapy ◽  
Lymphovascular Invasion ◽  
Univariate Analysis ◽  
Preoperative Staging ◽  
Neoadjuvant Treatment ◽  
Pathology Report ◽  
T Stage ◽  
N Status

34 Background: Because gastric cancers stage ≥ T2 or ≥ N1 are considered for neoadjuvant treatment, accuracy of preoperative staging is critical. The purpose of this study was to identify preoperative staging accuracies of computed tomography scan (CT) and endoscopic ultrasound (EUS) in gastric cancer and their utilities in selecting patients for neoadjuvant therapy. Methods: Medical records of 8,260 patients with gastric or gastroesophageal adenocarcinoma (presented 1995-2013) were reviewed to identify those who underwent gastrectomy but not neoadjuvant treatment. We reviewed preoperative EUS reports and CT images to identify detailed T stage (based on AJCC 7thedition) and lymph node positivity (short axis diameter ≥ 6mm). T stage and N status were compared with those from the surgical pathology report. Clinicopathologic variables associated with incorrect preoperative staging were also examined. Results: We identified 187 patients who underwent preoperative staging by EUS (n = 145) and/or CT (n = 134) for gastrectomy. The accuracy, sensitivity, and specificity of EUS in distinguishing T1 from more advanced tumors were 82%, 78%, and 85%, respectively. In univariate analysis, tumor location and lymphovascular invasion were associated with incorrect EUS T staging. In multivariate analysis, variables associated with underestimation of EUS T stage was lymphovascular invasion (OR 7.51, 95% CI 1.91-29.5, p < 0.01) and Caucasian race (OR 3.75, 95% CI 1.31-10.75, p = 0.01). The accuracies, sensitivities, and specificities for N status were, respectively, 65%, 49%, and 79% with CT and 66%, 29%, and 95% with EUS. In univariate analysis, poor differentiation and lymphovascular invasion were associated with incorrect diagnosis of CT N status. In multivariate analysis, lymphovascular invasion was associated with false-negative (OR 3.79, 95% CI 1.34-10.7, p = 0.01), and differentiated histology was associated with false-positive CT N status (OR 7.14, 95% CI 2.00-25.44, p < 0.01). Conclusions: EUS has reasonable accuracy in T stage, while both CT and EUS have low sensitivities and high specificities in N status. These accuracies should be considered when selecting patients for neoadjuvant treatment.

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