OBJECTIVE: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) allows preoperative tissue confirmation of malignancy, but fear of tumour cell dissemination along the needle track has limited its use. We hypothesised that if tumour cell dissemination occurs with EUS-FNA, survival after complete resection would be impaired. We aimed to evaluate the association of preoperative EUS-FNA with long-term outcomes of patients with resected pancreatic cancer. DESIGN: Using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified patients with locoregional pancreatic cancer who underwent curative intent surgery from 1998 to 2009. The patients who received EUS-FNA within the peridiagnostic period were included in the EUS-FNA group. Patients who did not receive EUS evaluation or who underwent EUS without FNA were included in the non-EUS-FNA group. Overall survival and pancreatic cancer-specific survival were compared after controlling for relevant covariates. RESULTS: A total of 2034 patients with pancreatic cancer were included (90% pancreatic adenocarcinoma). Of these, 498 (24%) patients were in EUS-FNA group. Patients with multiple comorbidities and more recent diagnosis were more likely to receive EUS-FNA. In multivariate analysis, after controlling for age, race, gender, tumour histology, tumour stage, tumour grade, tumour location, SEER site, year of diagnosis, undergoing percutaneous aspiration/biopsy, Charlson Comorbidity Index, radiation and chemotherapy, EUS-FNA was marginally associated with improved overall survival (HR 0.84, 95% CI 0.72 to 0.99), but did not affect cancer-specific survival (HR 0.87, 95% CI 0.74 to 1.03). CONCLUSIONS: Preoperative EUS-FNA was not associated with increased risk of mortality. These data suggest that EUS-FNA can be safely performed for the work-up of suspicious pancreatic lesions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) allows preoperative tissue confirmation of malignancy, but fear of tumour cell dissemination along the needle track has limited its use. We hypothesised that if tumour cell dissemination occurs with EUS-FNA, survival after complete resection would be impaired. We aimed to evaluate the association of preoperative EUS-FNA with long-term outcomes of patients with resected pancreatic cancer. DESIGN: Using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified patients with locoregional pancreatic cancer who underwent curative intent surgery from 1998 to 2009. The patients who received EUS-FNA within the peridiagnostic period were included in the EUS-FNA group. Patients who did not receive EUS evaluation or who underwent EUS without FNA were included in the non-EUS-FNA group. Overall survival and pancreatic cancer-specific survival were compared after controlling for relevant covariates. RESULTS: A total of 2034 patients with pancreatic cancer were included (90% pancreatic adenocarcinoma). Of these, 498 (24%) patients were in EUS-FNA group. Patients with multiple comorbidities and more recent diagnosis were more likely to receive EUS-FNA. In multivariate analysis, after controlling for age, race, gender, tumour histology, tumour stage, tumour grade, tumour location, SEER site, year of diagnosis, undergoing percutaneous aspiration/biopsy, Charlson Comorbidity Index, radiation and chemotherapy, EUS-FNA was marginally associated with improved overall survival (HR 0.84, 95% CI 0.72 to 0.99), but did not affect cancer-specific survival (HR 0.87, 95% CI 0.74 to 1.03). CONCLUSIONS: Preoperative EUS-FNA was not associated with increased risk of mortality. These data suggest that EUS-FNA can be safely performed for the work-up of suspicious pancreatic lesions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
ENDOSCOPIC ULTRASONOGRAPHY; PANCREATIC CANCER
Authors: Linda S Lee; Dana K Andersen; Reiko Ashida; William R Brugge; Mimi I Canto; Kenneth J Chang; Suresh T Chari; John DeWitt; Joo Ha Hwang; Mouen A Khashab; Kang Kim; Michael J Levy; Kevin McGrath; Walter G Park; Aatur Singhi; Tyler Stevens; Christopher C Thompson; Mark D Topazian; Michael B Wallace; Sachin Wani; Irving Waxman; Dhiraj Yadav; Vikesh K Singh Journal: Pancreas Date: 2017 Nov/Dec Impact factor: 3.327
Authors: Somashekar G Krishna; Bhavana B Rao; Emmanuel Ugbarugba; Zarine K Shah; Alecia Blaszczak; Alice Hinton; Darwin L Conwell; Phil A Hart Journal: Surg Endosc Date: 2017-04-04 Impact factor: 4.584
Authors: Victoria G Aveson; Crisanta H Ilagan; Joanne F Chou; Mithat Gönen; Vinod P Balachandran; Jeffrey A Drebin; William R Jarnagin; Alice C Wei; T Peter Kingham; Michael I D'Angelica Journal: HPB (Oxford) Date: 2021-11-10 Impact factor: 3.842
Authors: Rawad Mounzer; Roy Yen; Carrie Marshall; Sharon Sams; Sanjana Mehrotra; Mohamed Sherif Said; Joshua C Obuch; Brian Brauer; Augustin Attwell; Norio Fukami; Raj Shah; Stuart Amateau; Matthew Hall; Lindsay Hosford; Robert Wilson; Amit Rastogi; Sachin Wani Journal: Endosc Int Open Date: 2016-06-21