Risk of peritoneal carcinomatosis by endoscopic ultrasound-guided fine needle aspiration for pancreatic cancer

Ikezawa, Kenji; Uehara, Hiroyuki; Sakai, Arata; Fukutake, Nobuyasu; Imanaka, Kazuho; Ohkawa, Kazuyoshi; Tanakura, Rena; Ioka, Tatsuya; Tanaka, Sachiko; Ishikawa, Osamu; Katayama, Kazuhiro

doi:10.1007/s00535-012-0693-x

Cited by 50 publications

(42 citation statements)

References 12 publications

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“…A multivariate analysis did not find a significant correlation between preoperative EUS-FNA and cancer recurrence in the stomach or peritoneal cavity [7] . Similar results were obtained in 2 other retrospective studies in which EUS-FNA did not increase the risk of tumor dissemination through the needle tract in pancreatic cancer [10,11] . Regarding mucinous pancreatic cystic lesions, the PIPE study was conducted to assess the frequency of postoperative peritoneal seeding in patients with intraductal papillary mucinous neoplasm.…”

Section: Risk Of Needle Tract Seeding Following Eus-fnasupporting

confidence: 79%

Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration

et al. 2017

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Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been widely used for diagnosis of both inflammatory and tumor lesions located in and adjacent to the gastrointestinal tract. EUS-FNA has been considered to be a safe technique with few complications, as shown in recent review articles in which EUS-FNA-related morbidity and mortality rates were reported to be <1%. It should be noted, however, that needle tract seeding, although uncommon, can occur after diagnostic EUS-FNA and that this complication affects the prognosis of patients. Although an accurate value for the frequency of needle tract seeding caused by EUS-FNA has not been reported, the numbers of case reports on needle tract seeding have been rapidly increasing, especially in Japan. These case reports regarding EUS-FNA-related needle tract seeding prompted us to reevaluate the safety of EUS-FNA because this complication may have a significant influence on patients' prognoses. In this review, we summarize the clinical features and outcomes of needle tract seeding after EUS on the basis of the previously reported cases and provide useful information to prevent and reduce this serious complication.

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Section: Risk Of Needle Tract Seeding Following Eus-fnasupporting

confidence: 79%

Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration

et al. 2017

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“…Because a majority of patients included in this study had benign intraductal papillary mucinous neoplasm, the results could not be applicable to patients with malignant solid tumours. A study by Ikezawa et al 17 reported that patients with pancreatic adenocarcinoma who had undergone EUS-FNA (n=56) did not significantly increase the risk of peritoneal carcinomatosis. The impact of EUS-FNA on survival was not reported in this study.…”

Section: Discussionmentioning

confidence: 97%

Preoperative endoscopic ultrasound-guided fine needle aspiration does not impair survival of patients with resected pancreatic cancer

Ngamruengphong

Swanson

Shah

et al. 2015

Gut

101

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“…In addition, EUS‐FNA has been noted to have a lower morbidity and mortality compared with surgical diagnostic techniques. It has also been reported that needle tract seeding is markedly reduced when using EUS‐FNA compared with core needle biopsy and image‐guided percutaneous FNA . Clinical guidelines describing indications and techniques of EUS‐FNA as well as the terminology and nomenclature of pancreatobiliary disease, ancillary tests, and post‐FNA management have become available …”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound‐guided pancreatic fine‐needle aspiration: Potential pitfalls in one institution's experience of 1212 procedures

Bergeron

Perry

Houser

et al. 2014

Cancer Cytopathology

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BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has emerged as the diagnostic modality of choice for mass lesions in the pancreas. The objective of the current study was to determine the accuracy and pitfalls of EUS-FNA in the diagnosis of pancreatic lesions in cases that involved follow-up surgical resection. METHODS: Cases of EUS-FNA of pancreatic lesions performed from 2007 to mid-2012 for which subsequent surgical resection was performed were retrieved from the department's database. The accuracy of the cytologic diagnosis was assessed using the histological diagnosis as the gold standard. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated. "Neoplastic," "suspicious," and "malignant" were classified as a positive cytologic diagnosis. In one calculation method, "atypical" was also included as a positive cytologic diagnosis whereas in another it was not considered to be a positive cytological result. The cases with a cytologic-histological discrepancy were reviewed to identify sources of errors.RESULTS: A total of 1212 cases from 1104 patients (518 women and 586 men; age range, 18-94 years [average age, 63.5 years]) were identified. Cytologic diagnoses included 52 unsatisfactory, 224 benign, 129 atypical, 140 neoplasm, 35 suspicious, and 632 malignant diagnoses. Of these cases, 397 patients had histological follow-up information available. The sensitivity, specificity, positive predictive value, and negative predictive value were 83.2%, 85.9%, 95.9%, and 56.1%, respectively, with atypical cases excluded from the analysis. When atypical cases were included as a positive cytologic diagnosis, the sensitivity, specificity, positive predictive value, and negative predictive value were 86.7%, 67.9%, 90.7%, and 58.5%, respectively, and were 73.7%, 87.7%, 95.6%, and 48.0%, respectively, when atypical cases were included as a negative cytologic diagnosis. The major difficulty in EUS-FNA cytology was to differentiate pancreatic mucinous neoplasms from contaminants of gastric mucosa. Other pitfalls included differentiating mucinous neoplasm from extensive pancreatic intraepithelial neoplasia, and endocrine tumor from nesidioblastosis versus acinar cell carcinoma or intrapancreatic spleen.CONCLUSIONS: EUS-FNA is a valuable tool for the diagnosis of pancreatic lesions, especially solid malignant tumors.Cytologic-radiological correlation is essential in differentiating pancreatic mucinous neoplasms from gastric mucosa, because the former usually are found to have characteristic features on imaging. Pathologists should be aware of the pitfalls in the cytologic diagnosis of pancreatic lesions that may significantly change the clinical management of the patients.Cancer (Cancer Cytopathol) 2015;123:98-107.

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Risk of peritoneal carcinomatosis by endoscopic ultrasound-guided fine needle aspiration for pancreatic cancer

Abstract: EUS-FNA for pancreatic cancer did not significantly increase the risk of peritoneal carcinomatosis.

Cited by 50 publications

References 12 publications

Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration

Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration

Preoperative endoscopic ultrasound-guided fine needle aspiration does not impair survival of patients with resected pancreatic cancer

Endoscopic ultrasound‐guided pancreatic fine‐needle aspiration: Potential pitfalls in one institution's experience of 1212 procedures

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