Kim Sun Hwa, Woo Young Sik, Lee Kwang Hyuck, Lee Jong Kyun, Lee Kyu Taek, Park Joo Kyung, Kang Soo Hoon, Kim Ji Won, Park Jae Keun, Park Sung-Wook
Department of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
Gastrointest Endosc. 2018 Dec;88(6):926-934. doi: 10.1016/j.gie.2018.06.024. Epub 2018 Jul 4.
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.
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.
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 = .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).
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.
超声内镜引导下细针穿刺抽吸术（EUS-FNA）是一种用于胰腺癌的准确且相对安全的组织确诊方法。然而，人们担心该操作可能会使肿瘤细胞沿针道或在腹膜内播散。我们旨在评估术前EUS-FNA对切除的胰腺癌患者腹膜复发风险和长期预后的影响。
我们回顾性分析了2009年至2013年间诊断为胰腺癌并接受根治性切除术的患者记录，以研究总生存期、无癌生存期和腹膜复发情况。腹膜复发根据影像学检查结果或细胞学确诊的腹水进行诊断。
411例患者中，90例接受了术前EUS-FNA（EUS-FNA组），而321例未接受（非EUS-FNA组）。中位随访时间为16.2个月（范围2 - 46个月）。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）。两组间无癌生存期或总生存期无显著差异：EUS-FNA组中位总生存期为25.3个月，非EUS-FNA组为23.7个月（P = 0.36）；EUS-FNA组中位无癌生存期为12.7个月，非EUS-FNA组为11.6个月（P = 0.38）。
胰腺癌术前EUS-FNA与腹膜复发率或死亡率增加无关。因此，EUS-FNA是获取可疑胰腺肿块组织的准确且安全的方法。
