Endoscopy 2020; 52(S 01): S94
DOI: 10.1055/s-0040-1704286
ESGE Days 2020 oral presentations
Friday, April 24, 2020 11:00 – 13:00 Pancreatic solid tumors Liffey Meeting Room 1
© Georg Thieme Verlag KG Stuttgart · New York

IMPACT OF EUS AND EUS-GUIDED ASPIRATION (FNA) AND BIOPSY (FNB) ON MANAGEMENT OF PATIENTS WITH SUSPECTED PANCREATIC NEUROENDOCRINE TUMORS

M Zorniak
1   Chair and Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
,
M Wojcik
1   Chair and Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
,
P Dziadkiewicz
1   Chair and Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
,
M Chapula
1   Chair and Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
,
K Baranski
2   Department of Epidemiology, Medical University of Silesia, Katowice, Poland
,
M Kajor
3   Department of Patomorphology, Medical University of Silesia, Katowice, Poland
,
B Kos-Kudla
4   Department of Endocrinology and Neuroendocrine Tumors, Medical University of Silesia, Katowice, Poland
,
M Hartleb
1   Chair and Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
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Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

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Aims EUS has major impact on decision-making during diagnosis of pancreatic solid lesions. However, most of available evidence concerns suspicion of pancreatic adenocarcinoma (PDAC) and data focusing on influence of EUS in suspicion of pancreatic neuroendocrine tumor (PNET) is scarce. Importantly, management strategies differ substantially between PNETs and PDACs. Our aim was to retrospectively analyze influence of EUS in patients with suspected PNETs on major treatment decisions. We have also investigated safety of the procedure and differences in sampling between aspiration (FNA) and biopsy (FNB) needles.

Methods We have included 59 patients which have undergone EUS between 2017-2019. The suspicion of PNET was raised on the base of clinical symptomps and/or previous diagnostic imaging procedures. All patients were referred to our center to perform EUS after qualification carried out by Tumor Board of European Neuroendocrine Tumor Society (ENET) Excellence Centre. After procedure, EUS outomes were again presented to Tumor Board for final decision on treatment or further diagnostic procedures. Impact of EUS was considered as positive if it led to start of treatment (surgery, initiation or modification of chemotherapy) or appropriate follow-up. EUS was considered as negative when it led to supplementary diagnostic procedures due to the inability to make the final decision by Tumor Board.

Results In our study, EUS-FNA had a direct therapeutic impact for n=48/59 patients (81%). We have observed single case of post-procedure acute pancreatitis which caused prolonged hospitalization. Accuracy of sampling was significantly higher when FNB needles were used in comparison to FNA needles (p=0.001). Quality of specimen (including its length, possibilitty of performing specific staining and identification of Ki67%) correlated with increassing size of used needle (p< 0.005).

Conclusions EUS is a safe and efficient method for settling decisions when PNET is suspected. Accuracy of biopsy depends on size and type of needle - favoring FNB.