English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

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 shortand long-term outcomes. Methods: Between January 2012 and March 2015, 107 consecutive patients underwent resection for pancreatic adenocarcinoma were evaluated retrospectively. Shortand 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. Key word: Endoscopic ultrasound fine-needle aspiration, Pancreatic adenocarcinoma, Peritoneal dissemination Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo, Japan Department of Radiology, Graduate School of Medicine, the University of Tokyo, Japan Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Japan DOI: 10.21614/sgo-23-5-320 Surg. Gastroenterol. Oncol. 2018;23(5):320-329

surgery, gastroenterology and oncology

Comparison of Diagnostic Sensitivities for Resectable Pancreatic Adenocarcinoma Between Endoscopic Ultrasound-guided Fine-needle Aspiration and Blinded Computed Tomography