AIM: To address the role of a dedicated radiologist and high quality CT scanning in staging of patients referred with suspected locally advanced pancreatic cancer. Furthermore, the value of laparoscopy in detecting CT-occult metastases in these patients was assessed. METHODS: In a prospective cohort study, 116 patients with suspected unresectable pancreatic cancer referred from peripheral hospitals (107) or our own gastroenterology department (9) were analysed. CT scans from referral centres were reviewed and in case of locally advanced disease or uncertain metastatic disease, patients underwent a laparoscopy to detect CT-occult metastases. Patients without metastases were offered 5-FU based chemoradiotherapy. RESULTS: After reviewing 107 abdominal CT scans from referral centres, 73 (68%) scans had to be repeated due to unacceptable quality. Locally advanced disease was confirmed in 59 (55%) patients and metastatic disease was found in 24 patients (22%). During laparoscopy, metastases were found in 24/68 (35%) patients with locally advanced disease on CT scan and metastases were confirmed in 3/5 (60%) with suspected metastases. Overall, only 46/116 (40%) patients with suspected unresectable disease appeared to have locally advanced pancreatic cancer after adequate staging including laparoscopy in our centre. CONCLUSION: Correct staging is difficult in patients with suspected locally advanced pancreatic cancer and should preferably be performed in centres with technically advanced equipment and experienced radiologists. Laparoscopy should be offered to patients before locoregional therapy.
AIM: To address the role of a dedicated radiologist and high quality CT scanning in staging of patients referred with suspected locally advanced pancreatic cancer. Furthermore, the value of laparoscopy in detecting CT-occult metastases in these patients was assessed. METHODS: In a prospective cohort study, 116 patients with suspected unresectable pancreatic cancer referred from peripheral hospitals (107) or our own gastroenterology department (9) were analysed. CT scans from referral centres were reviewed and in case of locally advanced disease or uncertain metastatic disease, patients underwent a laparoscopy to detect CT-occult metastases. Patients without metastases were offered 5-FU based chemoradiotherapy. RESULTS: After reviewing 107 abdominal CT scans from referral centres, 73 (68%) scans had to be repeated due to unacceptable quality. Locally advanced disease was confirmed in 59 (55%) patients and metastatic disease was found in 24 patients (22%). During laparoscopy, metastases were found in 24/68 (35%) patients with locally advanced disease on CT scan and metastases were confirmed in 3/5 (60%) with suspected metastases. Overall, only 46/116 (40%) patients with suspected unresectable disease appeared to have locally advanced pancreatic cancer after adequate staging including laparoscopy in our centre. CONCLUSION: Correct staging is difficult in patients with suspected locally advanced pancreatic cancer and should preferably be performed in centres with technically advanced equipment and experienced radiologists. Laparoscopy should be offered to patients before locoregional therapy.
Authors: Mustafa Suker; Berend R Beumer; Eran Sadot; Lysiane Marthey; Jason E Faris; Eric A Mellon; Bassel F El-Rayes; Andrea Wang-Gillam; Jill Lacy; Peter J Hosein; Sing Yu Moorcraft; Thierry Conroy; Florian Hohla; Peter Allen; Julien Taieb; Theodore S Hong; Ravi Shridhar; Ian Chau; Casper H van Eijck; Bas Groot Koerkamp Journal: Lancet Oncol Date: 2016-05-06 Impact factor: 41.316
Authors: Antonino Spinelli; Daniele Del Fabbro; Matteo Sacchi; Alessandro Zerbi; Guido Torzilli; Fabio R Lutman; Luigi Laghi; Alberto Malesci; Marco Montorsi Journal: World J Surg Date: 2011-11 Impact factor: 3.352
Authors: Eva Versteijne; Casper H J van Eijck; Cornelis J A Punt; Mustafa Suker; Aeilko H Zwinderman; Miriam A C Dohmen; Karin B C Groothuis; Oliver R C Busch; Marc G H Besselink; Ignace H J T de Hingh; Albert J Ten Tije; Gijs A Patijn; Bert A Bonsing; Judith de Vos-Geelen; Joost M Klaase; Sebastiaan Festen; Djamila Boerma; Joris I Erdmann; I Quintus Molenaar; Erwin van der Harst; Marion B van der Kolk; Coen R N Rasch; Geertjan van Tienhoven Journal: Trials Date: 2016-03-09 Impact factor: 2.279
Authors: Mustafa Suker; Joost J Nuyttens; Bas Groot Koerkamp; Ferry A L M Eskens; Casper H J van Eijck Journal: J Surg Oncol Date: 2018-09-27 Impact factor: 3.454