Needle Tract Seeding after Endoscopic Ultrasound Tissue Acquisition of Pancreatic Lesions: A Systematic Review and Meta-Analysis

• Published in: Diagnostics (Basel) Vol. 12; no. 9; p. 2113
• Main Authors: Facciorusso, Antonio, Crinò, Stefano Francesco, Gkolfakis, Paraskevas, Ramai, Daryl, Mangiavillano, Benedetto, Londoño Castillo, Juliana, Chandan, Saurabh, Mohan, Babu P, D’Errico, Francesca, Decembrino, Francesco, Domislovic, Viktor, Anderloni, Andrea
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 31.08.2022; MDPI
• Subjects: Bias; Biopsy; cancer; Complications and side effects; Diagnosis; Endoscopic ultrasonography; Endoscopy; Estimates; EUS; FNA; FNB; Meta-analysis; Pancreatic tumors; Systematic Review; tumor; Ultrasonic imaging; Italy
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics12092113

There is limited evidence on the incidence of needle tract seeding (NTS) in patients undergoing endoscopic ultrasound (EUS) tissue acquisition (TA) of pancreatic lesions. This meta-analysis aimed to assess the incidence of NTS after EUS-TA. With a search of the literature up until April 2022, we identified 10 studies (13,238 patients) assessing NTS incidences in patients undergoing EUS-TA. The primary outcome was NTS incidence. The secondary outcome was a comparison in terms of peritoneal carcinomatosis incidence between patients who underwent EUS-TA and non-sampled patients. Results were expressed as pooled rates or odds ratio (OR) and 95% confidence intervals (CI). The pooled rate of NTS was 0.3% (95% CI 0.2–0.4%), with no evidence of heterogeneity (I2 = 0%). Subgroup analysis based on the type of sampled lesion confirmed this finding both in patients with pancreatic adenocarcinoma (0.4%, 0.2–0.6%) and in patients with cystic pancreatic lesions (0.3%, 0.1–0.5%). No difference in terms of metachronous peritoneal dissemination was observed between patients who underwent EUS-TA and non-sampled patients (OR 1.02, 0.72–1.46; p = 0.31), with evidence of low heterogeneity (I2 = 16%). Rates of NTS after EUS-TA are very low; therefore, EUS-TA could be safely performed in a pre-operative setting.