Background and Aims

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.

Methods

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.

Results

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).

Conclusions

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.

中文翻译：

---

术前EUS指导的FNA：对胰腺癌患者腹膜复发和生存的影响

背景和目标

EUS引导的FNA（EUS-FNA）是一种准确且相对安全的胰腺癌组织确认方法。然而，令人担心的是，该过程可能使肿瘤细胞沿针迹或在腹膜内扩散。我们旨在评估术前EUS-FNA对切除的胰腺癌腹膜复发风险和长期预后的影响。

方法

我们回顾性分析了2009年至2013年间接受过根治性切除术的诊断为胰腺癌的患者的记录，以研究其总体生存率，无癌生存率和腹膜复发率。根据影像学发现或经细胞学确认的腹水诊断出腹膜复发。

结果

在411例患者中，有90例接受了术前EUS-FNA治疗（EUS-FNA组），而321例则没有（非EUS-FNA治疗组）。随访的中位时间为16.2个月（范围2-46）。腹膜复发发生在131例患者中：EUS-FNA组为30％（27/90），而非EUS-FNA组为32％（P /  .66）。两组的无癌生存期或总生存期无显着差异：EUS-FNA组的中位总生存期中位数为25.3个月，非EUS-FNA组的中位总生存期为23.7个月（P  = 0.36）和中位无癌症EUS-FNA组的生存期为12.7个月，而非EUS-FNA组的生存期为11.6个月（P  = 0.38）。

结论

胰腺癌的术前EUS-FNA与腹膜复发或死亡率增加无关。因此，EUS-FNA是获得可疑胰腺肿块组织的准确和安全的方法。