Preoperative EUS-guided FNA: effects on peritoneal recurrence and survival in patients with pancreatic cancer
Preoperative EUS-guided FNA: effects on peritoneal recurrence and survival in patients with pancreatic cancer
复制标题
DOI：
10.1016/j.gie.2018.06.024
复制
发表时间：
2018-12-01
影响因子：
7.7
通讯作者：
Park, Sung-Wook
中科院分区：
文献类型：
--
作者：
Kim, Sun Hwa;Woo, Young Sik;Park, Sung-Wook
背景和目的：超声内镜引导下细针穿刺活检（EUS-FNA）是一种准确、相对安全的胰腺癌组织确认方法。然而，有人担心这种手术可能会使肿瘤细胞沿着针道或在腹膜内扩散。我们的目的是评估术前EUS-FNA对腹膜复发的风险和切除胰腺cancer.Methods的长期结局的影响：我们回顾性分析了2009年至2013年期间接受根治性切除术的胰腺癌患者的记录，以调查总生存率，无癌生存率和腹膜复发。腹膜复发的诊断是基于影像学表现或细胞学证实的腹水。结果：在411例患者中，90例接受术前EUS-FNA（EUS-FNA组），而321例没有（non-EUS-FNA组）。中位随访时间为16.2个月（范围，2-46）。131例患者发生腹膜复发：EUS-FNA组为30%（27/90），非EUS-FNA组为32%（104/321）（P = 0.66）。两组的无癌生存期或总生存期无显著差异：EUS-FNA组的中位总生存期为25.3个月，非EUS-FNA组为23.7个月（P Z.36），EUS-FNA组的中位无癌生存期为12.7个月，而非EUS-FNA组为11.6个月结论：胰腺癌术前EUS-FNA与腹膜复发率或死亡率的增加无关。因此，EUS-FNA是获得可疑胰腺肿块组织的一种准确、安全的方法。
Background and Aims: EUS-guided FNA (EUS-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-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-FNA (EUS-FNA group), whereas 321 did not (non-EUS-FNA group). The median length of follow-up was 16.2 months (range, 2-46). 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 Z.36) and 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-FNA for pancreatic cancer was not associated with an increased rate of peritoneal recurrence or mortality. Therefore, EUS-FNA is an accurate and safe method to obtain suspicious pancreatic mass tissue.