RT Journal
A1 Suits J, Frazee R, Erickson RA
T1 ENdoscopic ultrasound and fine needle aspiration for the evaluation of pancreatic masses
JF Archives of Surgery
JO Archives of Surgery
YR 1999
FD June 1
VO 134
IS 6
SP 639
OP 643
DO 10.1001/archsurg.134.6.639
UL http://dx.doi.org/10.1001/archsurg.134.6.639
AB Hypothesis: 
    Endoscopic ultrasound (EUS) and endoscopic ultrasound–guided fine needle aspiration (EUS-FNA) are accurate for the preoperative staging of pancreatic ductal carcinoma.Design 
    Retrospective medical record review.Patients 
    A prospective registry of 98 patients having EUS-FNA for peripancreatic masses from April 1994 to April 1998 was analyzed.Main Outcome Measure 
    The accuracy of EUS-FNA for preoperative diagnosis and staging of peripancreatic neoplasms.Results 
    Ninety-eight patients, aged 41 to 91 years (mean age, 67 years) with peripancreatic masses were evaluated by EUS-FNA. All patients had initial computed tomography scanning with a mass seen in 49 patients, "fullness" to the pancreas in 28 patients, and no mass seen in 21 patients. Evaluation with EUS-FNA revealed 22 benign lesions, 18 T2 masses, 37 T3 masses, 1 T4 mass, and 20 masses representing nonpancreatic tumors. Results of EUS-FNA of adjacent lymph nodes were positive in 27 patients. Twenty-seven patients had surgical resection or palliation permitting operative and pathologic staging. On comparison of EUS-FNA staging with surgical staging, 12 patients were the same stage, 14 patients were upstaged, and 1 patient was downstaged. The remaining patients who did not have surgery have been followed up for a mean of 15 months. Overall accuracy of EUS-FNA for differentiating benign from malignant masses was 96%.Conclusions 
    Endoscopic ultrasound–guided fine needle aspiration is a useful technique for the evaluation of pancreatic masses. It is highly accurate for differentiating between benign and malignant lesions and for predicting T stage, but is limited for predicting nodal status.