BACKGROUND: An accurate pre-therapeutic assessment of the resectability in pancreatic cancer patients is essential to reduce the number of futile surgical explorations. The aim of this study was to assess the combination of endoscopic ultrasound (EUS) and laparoscopic ultrasound (LUS) regarding the detection of patients with non-resectable tumours. PATIENTS AND METHODS: From 2002 to 2004, 179 consecutive patients with pancreatic cancer referred for surgical treatment were eligible. Thirty-one (17%) patients were excluded due to co-morbidity and poor performance status. Two patients (1%) were excluded due to metastasis seen on CT scans prior to referral. Thus, 146 patients entered the study. Patients were first examined with EUS followed by LUS, if EUS found no signs of non-resectability. Only patients with tumours found to be resectable or possibly resectable at EUS and LUS were offered surgical treatment. Resectability criteria were defined prior to the study. RESULTS: In all, 108 (74%) patients had non-resectable tumours by the pre-defined criteria. EUS identified 68 (63%) patients and LUS identified an additional 26 (24%) patients. Thus, a total of 94 (87%) patients were non-resectable at either EUS or LUS. Fifty-two (36%) patients underwent surgery. Six patients had surgical exploration and three patients had palliative surgery. Forty-three patients (29%) were resected with curative intention, of whom 38 (88%) had an R0 resection and 5 (12%) had a palliative resection. DISCUSSION: The combination of EUS and LUS is accurate in identifying the non-resectable patients and has a high predictive value for complete resection.
BACKGROUND: An accurate pre-therapeutic assessment of the resectability in pancreatic cancerpatients is essential to reduce the number of futile surgical explorations. The aim of this study was to assess the combination of endoscopic ultrasound (EUS) and laparoscopic ultrasound (LUS) regarding the detection of patients with non-resectable tumours. PATIENTS AND METHODS: From 2002 to 2004, 179 consecutive patients with pancreatic cancer referred for surgical treatment were eligible. Thirty-one (17%) patients were excluded due to co-morbidity and poor performance status. Two patients (1%) were excluded due to metastasis seen on CT scans prior to referral. Thus, 146 patients entered the study. Patients were first examined with EUS followed by LUS, if EUS found no signs of non-resectability. Only patients with tumours found to be resectable or possibly resectable at EUS and LUS were offered surgical treatment. Resectability criteria were defined prior to the study. RESULTS: In all, 108 (74%) patients had non-resectable tumours by the pre-defined criteria. EUS identified 68 (63%) patients and LUS identified an additional 26 (24%) patients. Thus, a total of 94 (87%) patients were non-resectable at either EUS or LUS. Fifty-two (36%) patients underwent surgery. Six patients had surgical exploration and three patients had palliative surgery. Forty-three patients (29%) were resected with curative intention, of whom 38 (88%) had an R0 resection and 5 (12%) had a palliative resection. DISCUSSION: The combination of EUS and LUS is accurate in identifying the non-resectable patients and has a high predictive value for complete resection.
Authors: K D Lillemoe; J L Cameron; J M Hardacre; T A Sohn; P K Sauter; J Coleman; H A Pitt; C J Yeo Journal: Ann Surg Date: 1999-09 Impact factor: 12.969
Authors: Antonio Soriano; Antoni Castells; Carmen Ayuso; Juan Ramón Ayuso; Maria Teresa de Caralt; Maria Angels Ginès; Maria Isabel Real; Rosa Gilabert; Llorenç Quintó; Antoni Trilla; Faust Feu; Xavier Montanyà; Laureano Fernández-Cruz; Salvador Navarro Journal: Am J Gastroenterol Date: 2004-03 Impact factor: 10.864
Authors: Els J M Nieveen van Dijkum; Mark G Romijn; Caroline B Terwee; Laurens Th de Wit; Jan H P van der Meulen; Han S Lameris; Erik A J Rauws; Huug Obertop; Casper H J van Eyck; Patrick M M Bossuyt; Dirk J Gouma Journal: Ann Surg Date: 2003-01 Impact factor: 12.969
Authors: Henricus J M Handgraaf; Martin C Boonstra; Arian R Van Erkel; Bert A Bonsing; Hein Putter; Cornelis J H Van De Velde; Alexander L Vahrmeijer; J Sven D Mieog Journal: Biomed Res Int Date: 2014-07-15 Impact factor: 3.411
Authors: Paul D James; Zhao Wu Meng; Mei Zhang; Paul J Belletrutti; Rachid Mohamed; William Ghali; Derek J Roberts; Guillaume Martel; Steven J Heitman Journal: PLoS One Date: 2017-03-20 Impact factor: 3.240