Endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

• Published in: Revista española de enfermedades digestivas Vol. 101; no. 9; pp. 631 - 638
• Main Authors: Iglesias García, J, Lariño Noia, J, Domínguez Muñoz, J E
• Format: Journal Article
• Language: English
• Published: Spain Sociedad Española de Patología Digestiva 01.09.2009; Aran Ediciones
• Subjects: Acute Disease; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Biopsy, Fine-Needle - adverse effects; Biopsy, Fine-Needle - methods; Cohort Studies; Diagnosis; Diagnosis, Differential; Endoscopic ultrasound; Endosonography; Gastroenterology & Hepatology; Geriatrics & Gerontology; Humans; Infectious Diseases; Lymphatic Metastasis - diagnostic imaging; Neoplasm Staging; Oncology; Pancreas - pathology; Pancreatic cancer; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Pancreatitis - etiology; Pathology; Pharmacology & Pharmacy; Prognosis; Prospective Studies; Radiology, Nuclear Medicine & Medical Imaging; Retrospective Studies; Risk Factors; Sensitivity and Specificity; Stanging; Surgery; Tomography, X-Ray Computed; Stanging; Diagnosis; Pancreatic cancer; Endoscopic ultrasound
• ISSN: 1130-0108; 1130-0108
• DOI: 10.4321/S1130-01082009000900006

Pancreatic cancer is the 5th leading cause of cancer-related death in Western countries. The 5-year survival rate is approximately 4%, without significant changes over the last 50 years. This poor survival rate and bad prognosis are associated with the diagnosis of advanced-stage disease, which precludes the only potential curative treatment - surgical resection. In this setting, the main objective in the management of pancreatic cancer is to perform an early diagnosis and a correct staging of the disease. Endoscopic ultrasonography (EUS) appears to be an essential tool for the diagnosis and staging of pancreatic cancer. EUS diagnostic accuracy for detecting pancreatic tumors ranges from 85 to 100%, clearly superior to other imaging techniques. EUS accuracy for the local staging of pancreatic cancer ranges from 70 to 90%, superior or equivalent to other imaging modalities. EUS-guided fine-needle aspiration allows a cyto-histological diagnosis in nearly 90% of cases, with a very low complication rate. At present, the formal indications for EUS-guided fine-needle aspiration are the necessity of palliative treatment or whenever the possibility of neoadjuvant treatment is present. It could be also indicated to differentiate pancreatic adenocarcinoma from other pancreatic conditions, like lymphoma, metastasis, autoimmune pancreatitis or chronic pancreatitis. We can conclude that EUS is an essential tool in the management of patients with pancreatic tumors.