Incidence of benign disease in patients that underwent resection for presumed pancreatic cancer diagnosed by endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA).

Published

Journal Article

INTRODUCTION: The lack of accurate markers makes preoperative differentiation between pancreatic cancer and non-malignant head lesions clinically challenging. In this study, we investigated the incidence of benign disease in patients that underwent resection for presumed pancreatic cancer diagnosed by EUS and EUS-guided FNA. METHODS: Medical records of consecutive patients who underwent pancreaticoduodenectomy at Duke University were reviewed. Demographics, clinicopathologic characteristics, preoperative imaging, EUS, EUS-guided FNA, and postoperative outcomes were analyzed. RESULTS: Seven percent of the total 494 patients studied were found to have benign disease on postoperative pathology. Fifty-nine percent of these patients with benign disease underwent preoperative EUS. EUS was positive for a head mass in 70%, demonstrated enlarged lymph nodes in 27%, and showed signs concerning for vascular invasion in 13%. FNA was suspicious or indeterminate for cancer in 63% of patients. Postoperative complications occurred in 47% and one patient died after surgery. The overall pancreatic leak rate was 15%. CONCLUSIONS: Even with aggressive use of preoperative evaluation, there is still a small subset of patients where malignancy cannot be excluded without pancreaticoduodenectomy.

Full Text

Duke Authors

Cited Authors

  • de la Fuente, SG; Ceppa, EP; Reddy, SK; Clary, BM; Tyler, DS; Pappas, TN

Published Date

  • July 2010

Published In

Volume / Issue

  • 14 / 7

Start / End Page

  • 1139 - 1142

PubMed ID

  • 20424928

Pubmed Central ID

  • 20424928

Electronic International Standard Serial Number (EISSN)

  • 1873-4626

Digital Object Identifier (DOI)

  • 10.1007/s11605-010-1196-9

Language

  • eng

Conference Location

  • United States