Non-negligible rate of needle tract seeding after endoscopic ultrasound-guided fine-needle aspiration for patients undergoing distal pancreatectomy for pancreatic cancer.
endoscopic ultrasound-guided fine-needle aspiration
pancreatectomy
pancreatic neoplasms
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
26
07
2019
revised:
08
12
2019
accepted:
19
12
2019
pubmed:
27
12
2019
medline:
29
7
2021
entrez:
27
12
2019
Statut:
ppublish
Résumé
Needle tract seeding after preoperative endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic body and tail cancer has been reported. This study aimed to investigate the long-term outcomes, including the needle tract seeding ratio, of patients undergoing distal pancreatectomy for pancreatic body and tail cancer diagnosed preoperatively by EUS-FNA. This retrospective, observational cohort study assessed patients from three university hospitals and 11 tertiary referral centers. All patients who underwent distal pancreatectomy for invasive cancer of the pancreatic body and tail between January 2006 and December 2015 were identified and reviewed. Needle tract seeding rate, recurrence-free survival (RFS), and overall survival (OS) were evaluated. Of the 301 total patients analyzed, 176 underwent preoperative EUS-FNA (EUS-FNA group) and 125 did not (non-EUS-FNA group). The median follow-up periods of the EUS-FNA group and non-EUS-FNA group were 32.8 and 30.1 months. Six patients (3.4%) in the EUS-FNA group were diagnosed as having needle tract seeding. The 5-year cumulative needle tract seeding rate estimated using Fine and Gray's method was 3.8% (95% CI 1.6-7.8%). The median RFS or OS was not significantly different between the EUS-FNA group and the non-EUS-FNA group (23.7 vs 16.9 months: P = 0.205; 48.0 vs 43.9 months: P = 0.392). Although preoperative EUS-FNA for pancreatic body and tail cancer has no negative effect on RFS or OS, needle tract seeding after EUS-FNA was observed to have a non-negligible rate. (UMIN000030719).
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Needle tract seeding after preoperative endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic body and tail cancer has been reported. This study aimed to investigate the long-term outcomes, including the needle tract seeding ratio, of patients undergoing distal pancreatectomy for pancreatic body and tail cancer diagnosed preoperatively by EUS-FNA.
METHODS
METHODS
This retrospective, observational cohort study assessed patients from three university hospitals and 11 tertiary referral centers. All patients who underwent distal pancreatectomy for invasive cancer of the pancreatic body and tail between January 2006 and December 2015 were identified and reviewed. Needle tract seeding rate, recurrence-free survival (RFS), and overall survival (OS) were evaluated.
RESULTS
RESULTS
Of the 301 total patients analyzed, 176 underwent preoperative EUS-FNA (EUS-FNA group) and 125 did not (non-EUS-FNA group). The median follow-up periods of the EUS-FNA group and non-EUS-FNA group were 32.8 and 30.1 months. Six patients (3.4%) in the EUS-FNA group were diagnosed as having needle tract seeding. The 5-year cumulative needle tract seeding rate estimated using Fine and Gray's method was 3.8% (95% CI 1.6-7.8%). The median RFS or OS was not significantly different between the EUS-FNA group and the non-EUS-FNA group (23.7 vs 16.9 months: P = 0.205; 48.0 vs 43.9 months: P = 0.392).
CONCLUSION
CONCLUSIONS
Although preoperative EUS-FNA for pancreatic body and tail cancer has no negative effect on RFS or OS, needle tract seeding after EUS-FNA was observed to have a non-negligible rate. (UMIN000030719).
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
801-811Informations de copyright
© 2019 Japan Gastroenterological Endoscopy Society.
Références
Chen G, Liu S, Zhao Y et al. Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer: A meta-analysis. Pancreatology 2013; 13: 298-304.
Bhatia V, Varadarajulu S. Endoscopic ultrasonography-guided tissue acquisition: How to achieve excellence. Dig. Endosc. 2017; 29: 417-30.
Motoi F, Satoi S, Honda G et al. A single-arm, phase II trial of neoadjuvant gemcitabine and S1 in patients with resectable and borderline resectable pancreatic adenocarcinoma: PREP-01 study. J. Gastroenterol. 2019; 54: 194-203.
de Geus SW, Eskander MF, Bliss LA et al. Neoadjuvant therapy versus upfront surgery for resected pancreatic adenocarcinoma: A nationwide propensity score matched analysis. Surgery 2017; 161: 592-601.
Shubert CR, Bergquist JR, Groeschl RT et al. Overall survival is increased among stage III pancreatic adenocarcinoma patients receiving neoadjuvant chemotherapy compared to surgery first and adjuvant chemotherapy: An intention to treat analysis of the National Cancer Database. Surgery 2016; 160: 1080-96.
Wang KX, Ben QW, Jin ZD et al. Assessment of morbidity and mortality associated with EUS-guided FNA: a systematic review. Gastrointest. Endosc. 2011; 73: 283-90.
Paquin SC, Gariepy G, Lepanto L et al. A first report of tumor seeding because of EUS-guided FNA of a pancreatic adenocarcinoma. Gastrointest. Endosc. 2005; 61: 610-1.
Ahmed K, Sussman JJ, Wang J et al. A case of EUS-guided FNA-related pancreatic cancer metastasis to the stomach. Gastrointest. Endosc. 2011; 74: 231-3.
Chong A, Venugopal K, Segarajasingam D et al. Tumor seeding after EUS-guided FNA of pancreatic tail neoplasia. Gastrointest. Endosc. 2011; 74: 933-5.
Katanuma A, Maguchi H, Hashigo S et al. Tumor seeding after endoscopic ultrasound-guided fine-needle aspiration of cancer in the body of the pancreas. Endoscopy 2012; 44(S 02 UCTN): E160-1
Sakurada A, Hayashi T, Ono M et al. A case of curatively resected gastric wall implantation of pancreatic cancer caused by endoscopic ultrasound-guided fine-needle aspiration. Endoscopy 2015; 47(S 01 UCTN): E198-9.
Minaga K, Kitano M, Yamashita Y. Surgically resected needle tract seeding following endoscopic ultrasound-guided fine-needle aspiration in pancreatic cancer. J Hepatobiliary Pancreat. Sci. 2015; 22: 708-9.
Tomonari A, Katanuma A, Matsumori T et al. Resected tumor seeding in stomach wall due to endoscopic ultrasonography-guided fine needle aspiration of pancreatic adenocarcinoma. World J. Gastroenterol. 2015; 21: 8458-61.
Minaga K, Kitano M, Enoki E et al. Needle-tract seeding on the proximal gastric wall after EUS-guided fine-needle aspiration of a pancreatic mass. Am. J. Gastroenterol. 2016; 111: 1515.
Iida T, Adachi T, Nakagaki S et al. Gastrointestinal: Needle tract implantation after endoscopic ultrasound-guided fine-needle aspiration of a pancreatic adenocarcinoma. J. Gastroenterol. Hepatol. 2016; 31: 285.
Sakamoto U, Fukuba N, Ishihara S et al. Postoperative recurrence from tract seeding after use of EUS-FNA for preoperative diagnosis of cancer in pancreatic tail. Clin. J. Gastroenterol. 2018; 11: 200-205.
Beane JD, House MG, Cote GA et al. Outcomes after preoperative endoscopic ultrasonography and biopsy in patients undergoing distal pancreatectomy. Surgery 2011; 150: 844-53.
Ngamruengphong S, Xu C, Woodward TA et al. Risk of gastric or peritoneal recurrence, and long-term outcomes, following pancreatic cancer resection with preoperative endosonographically guided fine needle aspiration. Endoscopy 2013; 45: 619-26.
Kudo T, Kawakami H, Kuwatani M et al. Influence of the safety and diagnostic accuracy of preoperative endoscopic ultrasound-guided fine-needle aspiration for resectable pancreatic cancer on clinical performance. World J. Gastroenterol. 2014; 20: 3620-7.
Ngamruengphong S, Swanson KM, Shah ND et al. Preoperative endoscopic ultrasound-guided fine needle aspiration does not impair survival of patients with resected pancreatic cancer. Gut 2015; 64: 1105-10.
Tsutsumi H, Hara K, Mizuno N et al. Clinical impact of preoperative endoscopic ultrasound-guided fine-needle aspiration for pancreatic ductal adenocarcinoma. Endosc. Ultrasound 2016; 5: 94-100.
Kim SH, Woo YS, Lee KH et al. Preoperative EUS-guided FNA: Effects on peritoneal recurrence and survival in patients with pancreatic cancer. Gastrointest. Endosc. 2018; 88: 926-34.
Yamao K. Complications of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) for pancreatic lesions. J. Gastroenterol. 2005; 40: 921-3.
Cotton PB, Eisen GM, Aabakken L et al. A lexicon for endoscopic adverse events: Report of an ASGE workshop. Gastrointest. Endosc. 2010; 71: 446-54.
Fine JGR. A proportional hazards model for the subdistribution of a competing risk. J. Am. Stat. Assoc. 1999; 94: 496-509.
Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2013; 48: 452-8.
Eloubeidi MA, Decker GA, Chandrasekhara V et al. The role of endoscopy in the evaluation and management of patients with solid pancreatic neoplasia. Gastrointest. Endosc. 2016; 83: 17-28.
Jenssen C, Hocke M, Fusaroli P et al. EFSUMB guidelines on interventional ultrasound (INVUS), part IV - EUS-guided interventions: General aspects and EUS-guided sampling (short version). Ultraschall Med. 2016; 37: 157-69.
Dumonceau JM, Deprez PH, Jenssen C et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline - Updated January 2017. Endoscopy 2017; 49: 695-714.
Groot VP, Rezaee N, Wu W et al. Patterns, timing, and predictors of recurrence following pancreatectomy for pancreatic ductal adenocarcinoma. Ann. Surg. 2018; 267: 936-45.
Van den Broeck A, Sergeant G, Ectors N et al. Patterns of recurrence after curative resection of pancreatic ductal adenocarcinoma. Eur. J. Surg. Oncol. 2009; 35: 600-4.