Preoperative EUS-guided fine-needle aspiration: effects on peritoneal recurrence and survival in patients with pancreatic cancer.Kim SH, Woo YS, Lee KH, Lee JK, Lee KT, Park JK, Kang SH, Kim JW, Park JK, Park SW. Gastrointest Endosc. 2018 Jul 4. [Epub ahead of print]

BACKGROUND AND AIMS: Endoscopic ultrasound-guided fine-needle aspiration (EUS-guided FNA) is an accurate and relatively safe tissue confirmation method for pancreatic cancer. However, there is concern that this procedure may spread tumor cells along the needle track or within the peritoneum. We aimed to estimate the effect of preoperative EUS-guided FNA on the risk of peritoneal recurrence and long-term outcomes in resected pancreatic cancer.

METHODS: We retrospectively reviewed records of patients diagnosed with pancreatic cancer who had undergone curative resection between 2009 and 2013 to investigate the overall survival, cancer-free survival, and peritoneal recurrence. Peritoneal recurrence was diagnosed based on image findings or cytology-confirmed ascites. RESULTS: Of 411 patients, 90 underwent preoperative EUS-guided FNA (EUS-FNA group) whereas 321 did not (non-EUS-FNA group). The median length of follow-up was 16.2 months (range, 2 to 46 months). Peritoneal recurrence occurred in 131 patients: 30% (27/90) in the EUS-FNA group versus 32% (104/321) in the non-EUS-FNA group (P = .66). Cancer-free survival or overall survival was not significantly different between the 2 groups: median overall survival of 25.3 months in the EUS-FNA group versus 23.7 months in the non-EUS-FNA group (P = .36); median cancer free survival of 12.7 months in the EUS-FNA group versus 11.6 months in the non-EUS-FNA group (P = .38).CONCLUSIONS: Preoperative EUS-guided FNA for pancreatic cancer was not associated with an increased rate of peritoneal recurrence or mortality. Therefore, EUS-guided FNA is an accurate and safe method to obtain suspicious pancreatic mass tissue. Leggi l'articolo


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