Role of endoscopic ultrasonography in the diagnosis and preoperative staging of pancreatic cancer

Background and Aims: Endoscopic ultrasonography (EUS) is a diagnostic method designed for the accurate detection and staging of tumors of the pancreas. It is often performed because of a clinical suspicion of pancreatic cancer, when the results of other noninvasive diagnostic tests are indeterminate. The aim of this study was to determine the accuracy of EUS in the diagnosis and staging of pancreatic cancer.

Patients and Methods: Patients with a suspicion of pancreatic cancer who had undergone CT and EUS were retrospectively reviewed. In those who participated in surgery, the surgical and/or pathological findings and staging were compared with the results of EUS. Resectability rates were determined and compared with the preoperative TNM staging by EUS.

Results: A total of 56 patients (30 females, 26 males) with a possible pancreatic mass underwent CT and EUS. The mean follow-up time was 10 months (3–30). The sensitivity, specificity, positive and negative predictive value and accuracy of the diagnosis of pancreatic cancer by EUS were 92%, 84%, 88, 89, and 88%, respectively. The accuracy of EUS for T and N staging proved to be 66% and 66%, respectively. The overall proportion of tumors that were deemed resectable by EUS and were actually found to be resectable during surgical exploration was 37%.

Conclusions: Radial EUS of the pancreas is an accurate method for the diagnosis and staging of pancreatic cancer.