Ragheb Jonathan G, Simons-Linares C Roberto, Pluskota Christopher, Confer Bradley, Butler Robert, Diehl David L, Khara Harshit S, Johal Amitpal S, Walsh R Matthew, Chahal Prabhleen
Department of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic Florida, Weston, Florida, United States.
Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, United States.
Endosc Int Open. 2023 Apr 24;11(4):E401-E408. doi: 10.1055/a-2046-4984. eCollection 2023 Apr.
Up to 80 % of patients with pancreatic adenocarcinoma develop locoregional recurrence after primary resection. However, the detection of recurrent pancreatic ductal adenocarcinoma (RPDAC) after pancreatic surgery can be challenging because of difficulty distinguishing locoregional recurrence from normal postoperative or post-radiation changes. We sought to evaluate the utility of endoscopic ultrasound (EUS), in detecting pancreatic adenocarcinoma recurrence after surgical resection and its impact on the clinical management of patients. This was a retrospective study of all pancreatic cancer patients who underwent EUS post-resection at two tertiary care centers between January 2004 and June 2019. Sixty-seven patients were identified. Of these, 57 (85 %) were diagnosed with RPDAC, resulting in change in clinical management of 46 (72 %) patients. EUS identified masses not seen on computed tomography, magnetic resonance imaging, or positron emission tomography in seven (14 %). EUS is useful in detecting RPDAC after pancreatic surgery and can lead to significant impact on clinical management.
高达80%的胰腺腺癌患者在初次切除后会发生局部区域复发。然而,由于难以区分局部区域复发与正常术后或放疗后改变,胰腺手术后复发性胰腺导管腺癌(RPDAC)的检测可能具有挑战性。我们试图评估内镜超声(EUS)在检测手术切除后胰腺腺癌复发中的效用及其对患者临床管理的影响。这是一项对2004年1月至2019年6月期间在两个三级医疗中心接受切除术后EUS检查的所有胰腺癌患者的回顾性研究。共确定了67例患者。其中,57例(85%)被诊断为RPDAC,导致46例(72%)患者的临床管理发生改变。EUS在7例(14%)患者中发现了计算机断层扫描、磁共振成像或正电子发射断层扫描未显示的肿块。EUS有助于检测胰腺手术后的RPDAC,并可对临床管理产生重大影响。