Abstract
Background
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate method for cytological confirmation of pancreatic malignancy, but peritoneal dissemination caused by EUS-FNA could be a matter of concern because it may lead to poorer prognosis. Our aim was to estimate the risk of peritoneal carcinomatosis by EUS-FNA for pancreatic cancer.
Methods
Two hundred and seventeen patients with cytopathologically proven pancreatic cancer in a tertiary referral center were retrospectively reviewed. They were divided into two groups: 161 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) alone (ERCP group), and 56 patients who had ever undergone EUS-FNA (EUS-FNA group). Peritoneal carcinomatosis was diagnosed by computed tomography and/or cytology during follow-up. Hazard ratios of factors including EUS-FNA for the development of peritoneal carcinomatosis were analyzed by the Cox proportional hazard model.
Results
There was no significant difference in baseline characteristics between ERCP and EUS-FNA groups. Peritoneal carcinomatosis developed in 14.9 % (24/161) during an average follow-up period of 545 days, and 17.9 % (10/56) during 599 days among ERCP and EUS-FNA group, respectively. The EUS-FNA was not identified as a significant risk factor with hazard ratios (HR) of 1.07 [95 % confidence interval (CI) 0.51–2.25, p = 0.85] by univariate analysis and 1.35 (95 % CI 0.62–2.95, p = 0.45) by multivariate analysis. Nodal involvement (HR 2.19, 95 % CI 1.03–4.63, p = 0.04) and non-resection (HR 2.64, 95 % CI 1.11–6.25, p = 0.03) were shown to be statistically significant risk factors by multivariate analysis.
Conclusions
EUS-FNA for pancreatic cancer did not significantly increase the risk of peritoneal carcinomatosis.
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Acknowledgments
We express our sincere appreciation to Dr. Akihiko Nakaizumi for the performance and supervision of ERCP and EUS-FNA) and Dr. Akemi Takenaka (cytological diagnosis of pancreatic cancer).
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The authors declare that they have no conflict of interest.
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Ikezawa, K., Uehara, H., Sakai, A. et al. Risk of peritoneal carcinomatosis by endoscopic ultrasound-guided fine needle aspiration for pancreatic cancer. J Gastroenterol 48, 966–972 (2013). https://doi.org/10.1007/s00535-012-0693-x
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DOI: https://doi.org/10.1007/s00535-012-0693-x