Surgery, Gastroenterology and Oncology
Official journal of the International Association of Surgeons, Gastroenterologists and Oncologists
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Comparison of Diagnostic Sensitivities for Resectable Pancreatic Adenocarcinoma Between Endoscopic Ultrasound-guided Fine-needle Aspiration and Blinded Computed Tomography
Background: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is performed for diagnosing pancreatic lesions. As EUS-FNA can develop needle track seeding, its use for radiographically-diagnosed pancreatic malignancy remains controversial.
We investigated a useful setting of EUS-FNA for resectable pancreatic adenocarcinoma by comparing the diagnostic sensitivity between EUS-FNA and contrast enhanced-computed tomography (CT), and by evaluating the short- and long-term outcomes.
Methods: Between January 2012 and March 2015, 107 consecutive patients underwent resection for pancreatic adenocarcinoma were evaluated retrospectively. Short- and longterm outcomes were compared between patients receiving EUS-FNA and patients who did not.
Results: EUS-FNA was performed for 52 patients (48.6%).Diagnostic sensitivity of EUS-FNA (90.4%) was significantly higher than for blinded CT(69.2%) (p=0.021). EUS-FNA accurately diagnosed pancreatic adenocarcinoma in 16 of 16 (100%) patients who had small tumor diameter, autoimmune pancreatitis, or IPMN-related tumor although they were not correctly diagnosed by radiographic findings.
In particular, the sensitivity of EUS-FNA was approximately 90%, irrespective of tumor size, while that for blinded CT was low in cases with a small tumor size (46% for TS1 tumor). Preoperative EUS-FNA was not associated with overall survival (p=0.958), recurrence-free survival (p=0.357), and relapse rate at peripancreatic tissue and or peritoneum(p=0.641).
Conclusion: EUS-FNA is particularly useful for diagnosing small pancreatic ductal adenocarcinoma, adenocarcinoma with pancreatitis or IPMN-related adenocarcinoma, providing high diagnostic sensitivity and acceptable prognostic outcomes.
Abbreviations: AC, adjuvant chemotherapy; ASA, American Society of Aesthesiologists; CA19-9, carbohydrate antigen 19-9; CE, contrast enhanced, CEA, carcinoembryonic antigen; CI, confidence interval; CT, computed tomography; DUPAN-2, duke pancreatic monoclonal antigen type 2; EUS, endoscopic ultrasound; FNA, fine-needle aspiration; HR, hazard ratio; IPMC, intrapapillary mucinous carcinoma; OS, overall survival; RFS, recurrence-free survival; Span-1, s-pancreas-1 antigen; TS, tumor size; UICC, International Union Against Cancer.
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Abstract:
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We investigated a useful setting of EUS-FNA for resectable pancreatic adenocarcinoma by comparing the diagnostic sensitivity between EUS-FNA and contrast enhanced-computed tomography (CT), and by evaluating the short- and long-term outcomes.
Methods: Between January 2012 and March 2015, 107 consecutive patients underwent resection for pancreatic adenocarcinoma were evaluated retrospectively. Short- and longterm outcomes were compared between patients receiving EUS-FNA and patients who did not.
Results: EUS-FNA was performed for 52 patients (48.6%).Diagnostic sensitivity of EUS-FNA (90.4%) was significantly higher than for blinded CT(69.2%) (p=0.021). EUS-FNA accurately diagnosed pancreatic adenocarcinoma in 16 of 16 (100%) patients who had small tumor diameter, autoimmune pancreatitis, or IPMN-related tumor although they were not correctly diagnosed by radiographic findings.
In particular, the sensitivity of EUS-FNA was approximately 90%, irrespective of tumor size, while that for blinded CT was low in cases with a small tumor size (46% for TS1 tumor). Preoperative EUS-FNA was not associated with overall survival (p=0.958), recurrence-free survival (p=0.357), and relapse rate at peripancreatic tissue and or peritoneum(p=0.641).
Conclusion: EUS-FNA is particularly useful for diagnosing small pancreatic ductal adenocarcinoma, adenocarcinoma with pancreatitis or IPMN-related adenocarcinoma, providing high diagnostic sensitivity and acceptable prognostic outcomes.
Abbreviations: AC, adjuvant chemotherapy; ASA, American Society of Aesthesiologists; CA19-9, carbohydrate antigen 19-9; CE, contrast enhanced, CEA, carcinoembryonic antigen; CI, confidence interval; CT, computed tomography; DUPAN-2, duke pancreatic monoclonal antigen type 2; EUS, endoscopic ultrasound; FNA, fine-needle aspiration; HR, hazard ratio; IPMC, intrapapillary mucinous carcinoma; OS, overall survival; RFS, recurrence-free survival; Span-1, s-pancreas-1 antigen; TS, tumor size; UICC, International Union Against Cancer.
Full Text Sources:
Abstract:
Views: 3333
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ISSN: 2559 - 723X (print)
e-ISSN: 2601 - 1700 (online)
ISSN-L: 2559 - 723X
Journal Abbreviation: Surg. Gastroenterol. Oncol.
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e-ISSN: 2601 - 1700 (online)
ISSN-L: 2559 - 723X
Journal Abbreviation: Surg. Gastroenterol. Oncol.
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Surgery, Gastroenterology and Oncology (SGO) is an open-access, peer-reviewed online journal published by Celsius Publishing House. The journal allows readers to read, download, copy, distribute, print, search, or link to the full text of its articles.
Surgery, Gastroenterology and Oncology (SGO) is an open-access, peer-reviewed online journal published by Celsius Publishing House. The journal allows readers to read, download, copy, distribute, print, search, or link to the full text of its articles.
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Time to first editorial decision: 25 days
Rejection rate: 61%
CiteScore: 0.2
Time to first editorial decision: 25 days
Rejection rate: 61%
CiteScore: 0.2
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