Gut Liver.
2022 May;16(3):474-482. 10.5009/gnl210123.
Prognosis and Clinical Characteristics of Patients with Pancreatic Ductal Adenocarcinoma Diagnosed by Endoscopic Ultrasonography but Indeterminate on Computed Tomography
- Ko SW
1 - Kim TH2
- Song TJ1
- Kim SH3
- Seo DW1
- Yoon JH4
- Cho CM5
- Cho JH6
- Choi JH7
- Lee DW8
- Lee SH9
- Yoon SB10
- Lee TH11
- Kim GH12
- Chun HJ13
- Affiliations
-
- 1Department of Gastroenterology, Asan Medical Center, Seoul, Korea.
- 2Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
- 3Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
- 4Division of Gastroenterology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
- 5Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
- 6Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea.
- 7Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
- 8Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea.
- 9Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
- 10Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 11Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University School of Medicine, Cheonan, Korea.
- 12Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
- 13Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea.
- KMID: 2529855
- DOI: http://doi.org/10.5009/gnl210123
Abstract
- Background/Aims
Endoscopic ultrasonography (EUS) provides high-resolution images and is superior to computed tomography (CT) scan in diagnosing small pancreatic ductal adenocarcinoma (PDAC). As a result, the use of EUS for early detection of PDAC has attracted attention. This study aimed to identify the clinical and radiological characteristics of patients with PDAC diagnosed by EUS but not found on CT scan.
Methods
The medical records of patients diagnosed with PDAC at 12 tertiary referral centers in Korea from January 2003 to April 2019 were reviewed. This study included patients with pancreatic masses not clearly observed on CT scan but identified on EUS. The clinical characteristics and radiological features of the patients were analyzed, and survival analysis was performed.
Results
A total of 83 patients were enrolled. The most common abnormal CT findings other than a definite mass was pancreatic duct dilatation, which was identified in 61 patients (73.5%). All but four patients underwent surgery. The final pathologic stages were as follows: IA (n=31, 39.2%), IB (n=8, 10.1%), IIA (n=20, 25.3%), IIB (n=17, 21.5%), III (n=2, 2.5%), and IV (n=1, 1.4%). The 5-year survival rate of these patients was 50.6% (95% confidence interval, 38.8% to 66.7%). Elevated liver function testing and R1 resection emerged as significant predictors of mortality in the multivariable Cox regression analysis.
Conclusions
This multicenter study demonstrated favorable long-term prognosis in patients with PDAC diagnosed by EUS but indeterminate on CT scan. EUS should be considered for patients with suspected PDAC but indeterminate on CT scan.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Synchronous Pancreatic Ductal Adenocarcinomas Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Biopsy
- Contrast-enhanced endoscopic ultrasound for pancreatobiliary disease
- Endoscopic Diagnosis in Pancreatic Cancer
- Ductal Adenocarcinoma Mimicking Intraductal Papillary Mucinous Neoplasm of the Pancreas
- Two Cases of Pancreatic Ductal Adenocarcinoma, Manifested as Solid Pseudopapillary Tumor and Intraductal Papillary Mucinous Neoplasm
