Division of Gastroenterology, Mayo Clinic Arizona, Scottsdale, Arizona 85259, USA.
Gastrointest Endosc. 2010 Jul;72(1):78-83, 83.e1-2. doi: 10.1016/j.gie.2010.01.072.
There is no direct evidence that EUS improves patient outcome.
To study the association of undergoing EUS with survival in patients with pancreatic adenocarcinoma.
Population-based study.
Persons aged 65 years and older with a diagnosis of pancreatic cancer who were captured in the linked Surveillance Epidemiology and End Results-Medicare database between 1994 and 2002 were identified.
Demographic, cancer-specific, and EUS procedural information was extracted, and survival curves were compared for patients who underwent EUS in the peridiagnostic period (1 month before the diagnosis to 3 months after the date of diagnosis: group I) with those who had not undergone EUS (group II).
Relative hazard ratios for survival.
A total of 8616 patients with pancreatic adenocarcinoma were identified. Only 610 (7.1%) patients underwent EUS evaluation. In patients with locoregional cancer, the median survival (interquartile range) in group I and II patients was 10 (5-17) and 6 (2-12) months, respectively, P < .0001. There were more patients with early-stage disease in group I than group II (69.3% vs 36.2%, P < .001). Curative-intent surgery, chemotherapy, and radiation therapy were also performed more frequently in the patients in group I. Undergoing EUS, adjusted for age, race, sex, tumor stage, curative-intent surgery, chemotherapy, radiation therapy, and comorbidity score, was an independent predictor of improved survival (relative hazard, 0.71; 95% CI, 0.63-0.79).
Retrospective design.
EUS evaluation is independently associated with improved outcome in patients with locoregional pancreatic cancer, possibly because of detection of earlier cancers and improved stage-appropriate management including more selective performance of curative-intent surgery.
目前尚无直接证据表明 EUS 可改善患者预后。
研究在胰腺腺癌患者中进行 EUS 检查与生存的关系。
基于人群的研究。
纳入 1994 年至 2002 年间在链接的监测、流行病学和最终结果-医疗保险数据库中诊断为胰腺癌且年龄≥65 岁的患者。
提取人口统计学、癌症特异性和 EUS 操作信息，并比较在诊断前 1 个月至诊断后 3 个月期间（I 组）进行 EUS 检查的患者与未进行 EUS 检查的患者（II 组）的生存曲线。
生存的相对危险比。
共纳入 8616 例胰腺腺癌患者，仅 610 例（7.1%）患者接受 EUS 评估。在局部区域癌症患者中，I 组和 II 组患者的中位生存时间（四分位间距）分别为 10（5-17）和 6（2-12）个月，P<0.0001。I 组患者中早期疾病患者比例高于 II 组（69.3%比 36.2%，P<0.001）。I 组患者更常接受根治性手术、化疗和放疗。在调整年龄、种族、性别、肿瘤分期、根治性手术、化疗、放疗和合并症评分后，进行 EUS 检查是改善生存的独立预测因素（相对危险比，0.71；95%CI，0.63-0.79）。
回顾性设计。
EUS 评估与局部胰腺癌症患者的转归改善独立相关，可能是因为更早地发现癌症，并进行了更具针对性的治疗，包括更有选择性地实施根治性手术。
