Premium
Clinical relevance of performing endoscopic ultrasound‐guided fine‐needle biopsy for pancreatic neuroendocrine tumors less than 2 cm
Author(s) -
Heidsma Charlotte M.,
Tsilimigras Diamantis I.,
Rocha Flavio,
Abbott Daniel E.,
Fields Ryan,
Smith Paula M.,
Poultsides George A.,
Cho Cliff,
Eijck Casper,
Dijkum Elisabeth Nieveen,
Maithel Shishir K.,
Pawlik Timothy M.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26158
Subject(s) - medicine , endoscopic ultrasound , concordance , fine needle aspiration , neuroendocrine tumors , biopsy , radiology , surgical pathology , pathology
Background We sought to define the diagnostic yield and concordance rates between endoscopic ultrasound (EUS)‐fine‐needle aspiration (FNA) and surgical pathology specimen following resection of pancreatic neuroendocrine tumors (pNET) less than 2 cm. Methods Patients with a pNET less than 2 cm who underwent EUS‐FNA were identified using a multi‐institutional international database. Tumor differentiation, and Ki‐67 index, as determined through EUS‐FNA were examined and concordance rates between EUS‐FNA and the surgical pathology were assessed. Results Among 628 patients with a pNET less than 2 cm, 57.2% of patients had an EUS‐FNA performed. Patients who underwent EUS had slightly smaller size tumors (1.3 vs 1.4 cm), and the pNETs were less likely to be functional (15.3% vs 26.8%) or symptomatic (48.5% vs 56.5%) (both P < .05). Among 314 patients with a pNET less than 2 cm who had an EUS‐FNA performed at the time of diagnosis, 243 (73.2%) had the diagnosis confirmed by preoperative EUS‐FNA. Tumor differentiation and Ki‐67 could be determined by EUS‐FNA in only 26.4% and 20.1% of patients, respectively. Concordance rate between EUS‐FNA and pathology was high relative to tumor differentiation (92.7%) and Ki‐67 (81.0%). Conclusion Tumor differentiation and Ki‐67 index could be determined by EUS‐FNA in only 26.4% and 20.1% of cases, respectively. Further studies should focus on EUS techniques to optimize diagnostic yield and cell extraction in the preoperative setting.