Preoperative endoscopic ultrasound-guided fine needle aspiration does not impair survival of patients with resected pancreatic cancer
- Study type
- Observational study
- Study name
- SEER-Medicare EUS-FNA
- Design
- Retrospective cohort study based on linked SEER-Medicare data
- Sample size
- 2034 patients
- Source
- Gut · 2015
In plain words
Sometimes, to confirm pancreatic cancer before surgery, a sample is taken with a fine needle guided by ultrasound from inside the stomach. There was a worry that this could spread cancer cells. In this study of more than 2000 patients who had surgery, survival was not worse in those who had this biopsy. So it appears safe to use it to check suspicious areas in the pancreas.
Key results
Treatment arms and regimens
Patients who underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) around the time of diagnosis (498 patients, 24%). Technical details in the full text.
Patients who had no EUS evaluation or had EUS without FNA.
Source of the regimen details: Abstract of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Patients with locoregional pancreatic cancer who underwent surgery with curative intent between 1998 and 2009. About 90% of patients had pancreatic adenocarcinoma.
Endpoints
Comparison of overall survival and pancreatic cancer-specific survival between the two groups after adjustment for relevant variables.
Safety and side effects
The abstract reports no data on procedural adverse events. The main finding was that EUS-FNA was not associated with an increased risk of death.
Clinical significance and place in guidelines
This observational study shows that concern about seeding of tumour cells along the needle tract is not a good reason to avoid preoperative EUS-FNA. However, because of the non-randomised design, clinical decisions should be based on each patient's circumstances and current authoritative guidelines, and the status of guideline recommendations should be checked separately.
Limitations
The design is observational and retrospective, with possible selection bias and residual confounding (for example, patients with more comorbidities were more likely to receive EUS-FNA). The borderline association with improved overall survival should not be interpreted as causal. Further details in the full text.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.