Vascular Invasion in Pancreatic Cancer

Téllez-Ávila, Félix Ignacio; Chavez-Tapia, Norberto C; López-Arce, Gustavo; Franco-Guzmán, Ada M.; Sosa-Lozano, Luis Antonio; Alfaro-Lara, Roberto; Chan-Nuñez, Carlos; Giovannini, Marc; Elizondo-Rivera, Javier; Ramírez-Luna, Miguel Ángel

doi:10.1097/mpa.0b013e31823e3632

Cited by 36 publications

(17 citation statements)

References 12 publications

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“…The primary characteristics of the studies are reported in table 1; they include the authors' names, publication year, number of cases, country, criterion standards, EUS type, and study site and design as well as whether the study was blind. Overall, 726 patients were enrolled, with a mean of 36 patients per study (range 11-89 patients) [9,11,12,13,14,15,16,20,21,22,23,24,25,26,27,28,29,30,31,32]. The data for evaluating EUS in the assessment of TN staging and of vascular invasion in PanCa were extracted from these studies.…”

Section: Resultsmentioning

confidence: 99%

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Endoscopic Ultrasonography for Tumor Node Staging and Vascular Invasion in Pancreatic Cancer: A Meta-Analysis

He²,

et al. 2014

Dig Surg

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Background/Aims: The accurate staging of pancreatic cancer (PanCa) is crucial in the development of a stage-specific treatment plan for PanCa patients. We aimed to perform a meta-analysis of endoscopic ultrasonography (EUS) in the tumor node (TN) staging and evaluation of vascular invasion in PanCa. Methods: A meta-analysis of diagnostic accuracy parameters was performed to evaluate the EUS-based TN staging, and vascular invasion by PanCa was compared to the results of intraoperative staging or to the histopathology of resected specimens. Results: Twenty studies with 726 PanCa cases were identified from 281 articles. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were 0.72, 0.90, 6.27, 0.28, and 24.69, respectively, for T1-2 staging and 0.90, 0.72, 3.58, 0.16, and 24.69, respectively, for T3-4 staging. The overall sensitivity, specificity, PLR, NLR, and DOR were 0.62, 0.74, 2.54, 0.51, and 6.67, respectively, for N staging (positive vs. negative) and 0.87, 0.92, 7.16, 0.20, and 56.19, respectively, for vascular invasion. The area under the curve was 0.90, 0.90, 0.79, and 0.94 for T1-2 staging, T3-4 staging, N staging, and vascular invasion, respectively. Conclusions: EUS is a reliable and accurate diagnostic tool for the TN staging and evaluation of vascular invasion in PanCa. The nodal staging accuracy using EUS is less satisfactory. i 2014 S. Karger AG, Basel

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Section: Resultsmentioning

confidence: 99%

“…EUS is a useful tool for evaluating vascular invasion in PanCa patients with, and it is particularly sensitive for, arterial invasion [30]. The accuracy rate of detecting vascular invasion using EUS is reportedly between 78 and 100% [20,25].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasonography for Tumor Node Staging and Vascular Invasion in Pancreatic Cancer: A Meta-Analysis

He²,

et al. 2014

Dig Surg

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“…The manuscripts of shortlisted articles were retrieved and assessed. Twenty studies were excluded [18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37] and 29 were included in the analysis based on the criteria mentioned above and summarized in Figure 1 [8, 10, 11, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63]. The first author, year of publication, number of patients included, and type of echo endoscope used for each of the 29 selected studies are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 29 studies included in this analysis, 16 studies examined nodal staging [10, 11, 38, 41, 43, 44, 45, 47, 49, 51, 53, 54, 56, 61, 63] for a total number of 512 patients, 25 examined vascular invasion [8, 10, 11, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 50, 51, 52, 53, 54, 55, 56, 57, 58, 61, 62] for a total number of 886 patients, and 9 examined resectability [8, 46, 47, 48, 53, 54, 55, 59, 60] for a total number of 377 patients. There was moderate to high degree of heterogeneity in the studies for each of the conditions as is evident in the forest plots in Figure 2.…”

Section: Resultsmentioning

confidence: 99%

Performance Characteristics of Endoscopic Ultrasound in the Staging of Pancreatic Cancer: A Meta-Analysis

Nawaz

Fan

Kloke

et al. 2013

JOP. Journal of the Pancreas

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“…[10] MRI can be useful in the detection of cystic neoplasms. [11] Since 18F-FDG-PET is not recommended, endoscopic US is useful to complement other imaging techniques [12] and when a tissue diagnosis is needed. [3] The definitions of resectability and borderline resectability are still not clear and certainly differ among centers and surgeons.…”

Section: Discussionmentioning

confidence: 99%

Comparison of preoperative imaging and pathological findings for pancreatic head adenocarcinoma

et al. 2017

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Initial imaging of pancreatic ductal adenocarcinoma is of crucial importance in the decision-making process. The aim of this study was to compare preoperative imaging, pathological data, and outcomes in a series of patients who underwent resection for pancreatic head cancer.From January 2004 to December 2009, data were collected by the Association Française de Chirurgie on 1044 patients who received first-line R0 resection of pancreatic head cancer.On imaging (computed tomography scan 97%, echoendoscopic ultrasound 61.3%, magnetic resonance imaging 46.5%), arterial, venous, or lymph node invasion was suspected in 20, 161, and 197 patients, respectively; arterial, venous, or lymph node invasion was observed histologically in 11, 116, and 736 cases, respectively. In the patients for whom both imaging and pathological data were available, the concordance, sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 97.5%, 27.3%, 98%, 20%, and 99%, for arterial invasion; 86.5%, 54%, 91%, 47.8%, and 93.2%, for venous invasion; and 38%, 21%, 86%, 78%, and 41%, respectively, for lymph node invasion. Imaging of arterial invasion had no prognostic value, while histological evidence of invasion was associated with a poor prognosis. Venous and lymph node invasion, as demonstrated by imaging and by pathological analysis, had an adverse prognostic value.Imaging gives a fair positive predictive value for venous or arterial invasion; venous invasion on imaging and histology was associated with a poor prognosis; arterial invasion on imaging does not have any significant prognostic value.

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Vascular Invasion in Pancreatic Cancer

Abstract: Endoscopic US is a very good option to detect vascular invasion in patients with pancreatic cancer and is especially sensitive for arterial invasion. When it is available, we recommend that it be performed in addition to CT staging.

Cited by 36 publications

References 12 publications

Endoscopic Ultrasonography for Tumor Node Staging and Vascular Invasion in Pancreatic Cancer: A Meta-Analysis

Endoscopic Ultrasonography for Tumor Node Staging and Vascular Invasion in Pancreatic Cancer: A Meta-Analysis

Performance Characteristics of Endoscopic Ultrasound in the Staging of Pancreatic Cancer: A Meta-Analysis

Comparison of preoperative imaging and pathological findings for pancreatic head adenocarcinoma

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