Impact of preoperative endoscopic ultrasound-guided fine needle aspiration on postoperative recurrence and survival in cholangiocarcinoma patients

Chafic, Abdul Hamid El; DeWitt, John M.; Leblanc, Julia K.; Hajj, Ihab I. El; Coté, Gregory A.; House, Michael G.; Sherman, Stuart; McHenry, Lee; Pitt, Henry A.; Johnson, Cynthia S.; Mohamadnejad, Mehdi; Al‐Haddad, Mohammad

doi:10.1055/s-0033-1344760

Cited by 85 publications

(47 citation statements)

References 24 publications

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“…The data on tract seeding rates in the presented study are missing. The study (2) echoes the recent report from the Indiana University group stating that EUS-guided fine-needle aspiration (FNA) did not influence CCA recurrence and patient survival after the curative-intent surgery (4). However, the median progression-free survival in the study from Indiana was 17.8 months (95% CI, 14.5–22.8), which is too dismal and short a time to observe the effect of tumor tract seeding on outcomes.…”

Section: To the Editorsupporting

confidence: 66%

Awareness of Tract Seeding With Endoscopic Ultrasound Tissue Acquisition in Perihilar Cholangiocarcinoma

Razumilava

Gleeson

Gores

2015

American Journal of Gastroenterology

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Section: To the Editorsupporting

confidence: 66%

Awareness of Tract Seeding With Endoscopic Ultrasound Tissue Acquisition in Perihilar Cholangiocarcinoma

Razumilava

Gleeson

Gores

2015

American Journal of Gastroenterology

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“…A Mayo Clinic study suggested that EUS with FNA may increase the risk of peritoneal seeding, 36 whereas a recent study suggested that FNA did not increase the risk of adverse events. 37 However, in centers where Mayo Clinic transplantation protocol is used for CCA, the patients are excluded if FNA is performed. However, EUS still plays a major role in lymph node staging of hilar CCA.…”

Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis

Navaneethan

Njei

Lourdusamy

et al. 2015

Gastrointestinal Endoscopy

401

347

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Background Evaluation of indeterminate biliary strictures typically involves collection and analysis of tissue or cells. Brush cytology and intraductal biopsies that are routinely performed during ERCP to assess malignant-appearing biliary strictures are limited by relatively low sensitivity. Objective To study the comparative effectiveness of brushings for cytology and intraductal biopsies in the etiology of biliary strictures. Design Meta-analysis. Setting Referral center. Patients PUBMED and Embase databases were reviewed for studies published to April 2014 where diagnostic correlation of histology was available. Intervention Database and review of study findings. Main Outcome Measurements Sensitivity and specificity. Results The pooled sensitivity and specificity of brushings for the diagnosis of malignant biliary strictures was 45% (95% confidence interval [CI], 40%–50%) and 99% (95% CI, 98%–100%), respectively. The pooled diagnostic odds ratio to detect malignant biliary strictures was 33.43 (95% CI, 14.29–78.24). For intraductal biopsies, the pooled sensitivity and specificity were 48.1% (95% CI, 42.8%–53.4%) and 99.2% (95% CI, 97.6%–99.8%), respectively. The pooled diagnostic odds ratio to detect malignant biliary strictures was 43.18 (95% CI, 19.39–95.83). A combination of both modalities only modestly increased the sensitivity (59.4%; 95% CI, 53.7%–64.8%) with a specificity of 100% (95% CI, 98.8%–100.0%). The Begg-Mazumdar and Egger tests indicated a low potential for publication bias. Limitations Inclusion of low-quality studies. Conclusion Our study suggests that both brushings and biopsy are comparable and have limited sensitivity for the diagnosis of malignant biliary strictures. A combination of both only modestly increases the sensitivity.

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“…Moreover, EUS-FNA may be considered in evaluating regional lymph nodes to evaluate for metastasis in patients with unresectable hilar cholangiocarcinoma [38,39] . EUS-FNA in patients with cholangiocarcinoma did not appear to adversely affect the overall survival [40] .…”

Section: B a B Amentioning

confidence: 77%

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

Hammoud

Almashhrawi

Ibdah

2014

WJGO

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cholangiocarcinoma" and "EUS and gallbladder" to retrieve articles published between 1999 to 2014.Hammoud GM, Almashhrawi A, Ibdah JA. Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions. World J Gastrointest Oncol 2014; 6(11): 420-429 Available from: URL: http://www.wjgnet.com/1948-5204/full/v6/i11/420.htm DOI: http://dx.doi.org/10.4251/wjgo.v6.i11.420 INTRODUCTIONEndoscopic ultrasonography (EUS) has become an indispensable diagnostic and therapeutic procedure in the field of gastroenterology coupling endoscopy with high frequency echo sonography. Endoscopic ultrasoundguided fine needle aspiration (EUS-FNA) is performed using the curved linear array echoendoscope (Figure 1) using various needles (Figure 2). The recently introduced forward viewing linear echoendoscope is gaining momentum in endoscopic ultrasound-guided interventions (Figure 1). EUS-FNA is minimally invasive that is utilized for procurement of tissue from unresectable tumors. EUS-guided fine needle aspiration is used increasingly for the diagnosis of mediastinal, pancreatic and gastric tumors, however, not much is known about EUS-FNA in hepatic lesions. EUS imaging of the liver is currently limited to the left lobe, the proximal right lobe, the hilum and part of the intrahepatic biliary tract. EUS-FNA may be considered as an alternative to liver percutaneous biopsy in patients at high risk of bleeding or with small lesions of the liver uncharacterized by cross-sectional abdominal imaging. EUS-guided biliary drainage (EUS-BD) was developed using a curved linear array echoendoscope for cases with failed endoscopic biliary drainage. Table 1 AbstractEndoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of the liver is a safe procedure in the diagnosis and staging of hepatobiliary malignancies with a minimal major complication rate. EUS-FNA is useful for liver lesions poorly accessible to other imaging modalities of the liver. EUS-guided FNA of biliary neoplasia and malignant biliary stricture is superior to the conventional endoscopic brushing and biopsy.

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Impact of preoperative endoscopic ultrasound-guided fine needle aspiration on postoperative recurrence and survival in cholangiocarcinoma patients

Abstract: Preoperative EUS-FNA in patients with CCA does not appear to adversely affect overall or progression-free survival.

Cited by 85 publications

References 24 publications

Awareness of Tract Seeding With Endoscopic Ultrasound Tissue Acquisition in Perihilar Cholangiocarcinoma

Awareness of Tract Seeding With Endoscopic Ultrasound Tissue Acquisition in Perihilar Cholangiocarcinoma

Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

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