Impact of endoscopic ultrasonography on diagnosis of pancreatic cancer

Kitano, Masayuki; Yoshida, Takeichi; Itonaga, Masahiro; Tamura, Takashi; Hatamaru, Keiichi; Yamashita, Yasunobu

doi:10.1007/s00535-018-1519-2

Cited by 234 publications

(187 citation statements)

References 139 publications

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“…Given the anatomical location and structure of the tumor, biopsy is sometimes difficult to perform and may delay treatment. The specificity of endoscopic ultrasound-guided biopsy is 96%, but the sensitivity is only 85.92% and repeated examinations are required in 11% of cases [18].…”

Section: Discussionmentioning

confidence: 99%

Effect of neoadjuvant radiotherapy on survival of non-metastatic pancreatic ductal adenocarcinoma: a SEER database analysis

et al. 2020

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Background: Neoadjuvant radiotherapy has been shown to improve marginal negative resection and local control of Pancreatic Ductal Adenocarcinoma (PDAC). However, whether it improves overall survival (OS) in patients with non-metastatic PDAC remains controversial. Therefore, the purpose of this study was to analyze the benefits of only surgery, neoadjuvant radiotherapy, adjuvant radiotherapy, and surgery plus chemotherapy for OS in patients with non-metastatic PDAC. Methods: PDAC diagnosed by surgical histopathology in the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016 was selected. Kaplan-Meier analysis was used to compare the prognosis of patients with different treatments. Cox proportional risk model was used to analyze independent predictors of OS. Propensity score matching (PSM) was used to analyze the tumor prognosis of different treatment methods. Results: Before PSM analysis, the OS of surgery plus chemotherapy (HRs = 0.896, 95%CIs, 0.827-0.970; P = 0.007) were significantly better than the other three treatments for stage T1-3N0M0 PDAC patients. For stage T1-3N + M0 patients, adjuvant radiotherapy (HRs = 0.613, 95% CIs, 0.579-0.649; P < 0.001) had significantly better OS than surgery plus chemotherapy and neoadjuvant radiotherapy. For stage T4N0M0 patients, neoadjuvant radiotherapy (HRs = 0.482, 95% CIs, 0.347-0.670; P < 0.001) had significantly better OS than surgery plus chemotherapy and adjuvant radiotherapy. For stage T4N + M0 patients, neoadjuvant radiotherapy (HRs = 0.338, 95% CIs, 0.215-0.532; P < 0.001) had significantly longer OS than adjuvant radiotherapy and surgery plus chemotherapy. Even after PSM, Chemotherapy plus surgery was still the best treatment for T1-3N0M0 patients. Postoperative adjuvant radiotherapy had the best prognosis among T1-3N + M0 patients, and neoadjuvant radiotherapy was the best treatment for T4 patients.

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Section: Discussionmentioning

confidence: 99%

Effect of neoadjuvant radiotherapy on survival of non-metastatic pancreatic ductal adenocarcinoma: a SEER database analysis

et al. 2020

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“…The diagnosis of PDAC is currently confirmed via endoscopic ultrasound (EUS) with fine-needle aspiration for cytologic analysis [ 12 , 13 ]. Management is multimodal and depends chiefly on staging with EUS and radiographic cross-sectional imaging, often with computed tomography (CT) [ 8 ].…”

Section: Pancreatic Cancer: the Need For A Novel Diagnosticmentioning

confidence: 99%

Current Status of Circulating Tumor DNA Liquid Biopsy in Pancreatic Cancer

Grunvald

Jacobson

Kuzel

et al. 2020

IJMS

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Pancreatic cancer is a challenging disease with a low 5-year survival rate. There are areas for improvement in the tools used for screening, diagnosis, prognosis, treatment selection, and assessing treatment response. Liquid biopsy, particularly cell free DNA liquid biopsy, has shown promise as an adjunct to our standard care for pancreatic cancer patients, but has not yet been universally adopted into regular use by clinicians. In this publication, we aim to review cfDNA liquid biopsy in pancreatic cancer with an emphasis on current techniques, clinical utility, and areas of active investigation. We feel that researchers and clinicians alike should be familiar with this exciting modality as it gains increasing importance in the care of cancer patients.

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“…An assessment of vascular invasion of PDAC using elastography has not been performed [13]. Therefore, the primary endpoint in this study was to compare diagnostic performance for vascular invasion among dynamic CT, EUS B-mode, and EUS-EG.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of vascular invasion in pancreatic ductal adenocarcinoma using endoscopic ultrasound elastography

et al. 2020

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Background: Vascular invasion is an important criterion for resectability and deciding the therapeutic strategy for pancreatic ductal adenocarcinoma (PDAC), but imaging diagnosis is currently difficult. Endoscopic ultrasound (EUS) elastography (EG) images have band-like artifacts on the border between tumor and vessel due to different movement if the tumor is not connected to the vessel, i.e., no invasion. Based on this phenomenon, we assessed the usefulness of EUS-EG in the diagnosis of vascular invasion in PDAC. Methods: The subjects were 44 out of 313 patients with PDAC who underwent EUS between January 2015 and November 2018, followed by surgery, no chemotherapy or radiotherapy, and pathological evaluation. Diagnostic accuracies of vascular invasion using dynamic computed tomography (CT), EUS B-mode and EUS-EG were compared with histopathological diagnosis. Results: In 44 subjects (48 sites) who underwent both dynamic CT and EUS-B mode, the sensitivity, specificity and accuracy were 0.733, 0.697 and 0.708 on dynamic CT (48 sites); 0.733, 0.606 and 0.646 in EUS B-mode (48 sites); and 0.917, 0.900 and 0.906 in EUS-EG (32 sites). In 27 subjects (29 sites) with a tumor contacting a vessel with no vascular obstruction or stenosis on dynamic CT, the sensitivity, specificity and accuracy were 0.556, 0.750 and 0.690 on dynamic CT; 0.667, 0.700 and 0.690 in EUS B-mode; and 0.889, 0.850 and 0.862 in EUS-EG. Conclusions: These results suggest that EUS combined with EG improves diagnostic performance of vascular invasion in PDAC, especially in cases of which vascular invasion cannot be clearly assessed by dynamic CT.

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Impact of endoscopic ultrasonography on diagnosis of pancreatic cancer

Cited by 234 publications

References 139 publications

Effect of neoadjuvant radiotherapy on survival of non-metastatic pancreatic ductal adenocarcinoma: a SEER database analysis

Effect of neoadjuvant radiotherapy on survival of non-metastatic pancreatic ductal adenocarcinoma: a SEER database analysis

Current Status of Circulating Tumor DNA Liquid Biopsy in Pancreatic Cancer

Diagnosis of vascular invasion in pancreatic ductal adenocarcinoma using endoscopic ultrasound elastography

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