TY - JOUR
T1 - Diagnostic performance of endoscopic tissue acquisition for pancreatic ductal adenocarcinoma in the PREOPANC and PREOPANC-2 trials
AU - Janssen, Quisette P.
AU - Quispel, Rutger
AU - Besselink, Marc G.
AU - Bonsing, Bert A.
AU - Bruno, Marco J.
AU - Doukas, Michael
AU - Sarasqueta, Arantza F.
AU - Homs, Marjolein Y. V.
AU - van Hooft, Jeanin E.
AU - van Tienhoven, Geertjan
AU - van Velthuysen, Marie-Louise F.
AU - Verheij, Joanne
AU - Voermans, Rogier P.
AU - Dutch Pancreatic Cancer Group
AU - Wilmink, Johanna W.
AU - Groot Koerkamp, Bas
AU - van Eijck, Casper H. J.
AU - van Driel, Lydi M. J. W.
N1 - Funding Information:
This study is supported by the Dutch Cancer Society (KWF) (UVA 2012–5696 and 10955) and by ZonMw (843004108). No funding agency was involved in the design of the study, or the collection, analysis, and interpretation of data. The authors are solely responsible for the content of the study and do not necessarily represent the viewpoint of the Dutch Cancer Society or ZonMw.
Funding Information:
This study is supported by the Dutch Cancer Society (KWF) ( UVA 2012–5696 and 10955 ) and by ZonMw ( 843004108 ). No funding agency was involved in the design of the study, or the collection, analysis, and interpretation of data. The authors are solely responsible for the content of the study and do not necessarily represent the viewpoint of the Dutch Cancer Society or ZonMw.
Publisher Copyright:
© 2023 The Authors
PY - 2023/10
Y1 - 2023/10
N2 - BACKGROUND: Neoadjuvant treatment for pancreatic ductal adenocarcinoma (PDAC) has increased, necessitating histopathologic confirmation of cancer. This study evaluates the performance of endoscopic tissue acquisition (TA) procedures for borderline resectable and resectable PDAC.METHODS: Pathology reports of patients included in two nationwide randomized controlled trials (PREOPANC and PREOPANC-2) were reviewed. The primary outcome was sensitivity for malignancy (SFM), considering both "suspicious for" and "malignant" as positive. Secondary outcomes were rate of adequate sampling (RAS) and diagnoses other than PDAC.RESULTS: Overall, 892 endoscopic procedures were performed in 617 patients, including endoscopic ultrasonography (EUS)-guided TA in 550 (89.1%), endoscopic retrograde cholangiopancreatography (ERCP)-guided brush cytology in 188 (30.5%), and periampullary biopsies in 61 patients (9.9%). The SFM was 85.2% for EUS, 88.2% for repeat EUS, 52.7% for ERCP, and 37.7% for periampullary biopsies. The RAS ranged 94-100%. Diagnoses other than PDAC were other periampullary cancers in 24 (5.4%), premalignant disease in five (1.1%), and pancreatitis in three patients (0.7%).CONCLUSIONS: EUS-guided TA of patients with borderline resectable and resectable PDAC included in RCTs had an SFM above 85% for both first and repeat procedures, meeting international standards. Two percent had false positive result for malignancy and 5% had other (non-PDAC) periampullary cancers.
AB - BACKGROUND: Neoadjuvant treatment for pancreatic ductal adenocarcinoma (PDAC) has increased, necessitating histopathologic confirmation of cancer. This study evaluates the performance of endoscopic tissue acquisition (TA) procedures for borderline resectable and resectable PDAC.METHODS: Pathology reports of patients included in two nationwide randomized controlled trials (PREOPANC and PREOPANC-2) were reviewed. The primary outcome was sensitivity for malignancy (SFM), considering both "suspicious for" and "malignant" as positive. Secondary outcomes were rate of adequate sampling (RAS) and diagnoses other than PDAC.RESULTS: Overall, 892 endoscopic procedures were performed in 617 patients, including endoscopic ultrasonography (EUS)-guided TA in 550 (89.1%), endoscopic retrograde cholangiopancreatography (ERCP)-guided brush cytology in 188 (30.5%), and periampullary biopsies in 61 patients (9.9%). The SFM was 85.2% for EUS, 88.2% for repeat EUS, 52.7% for ERCP, and 37.7% for periampullary biopsies. The RAS ranged 94-100%. Diagnoses other than PDAC were other periampullary cancers in 24 (5.4%), premalignant disease in five (1.1%), and pancreatitis in three patients (0.7%).CONCLUSIONS: EUS-guided TA of patients with borderline resectable and resectable PDAC included in RCTs had an SFM above 85% for both first and repeat procedures, meeting international standards. Two percent had false positive result for malignancy and 5% had other (non-PDAC) periampullary cancers.
KW - Humans
KW - Pancreatic Neoplasms/diagnostic imaging
KW - Cholangiopancreatography, Endoscopic Retrograde/methods
KW - Pancreatic Ducts/pathology
KW - Carcinoma, Pancreatic Ductal/diagnostic imaging
KW - Endosonography
KW - Endoscopic Ultrasound-Guided Fine Needle Aspiration
KW - biopsy
KW - endoscopic retrograde cholangiopancreatography
KW - endoscopic ultrasonography
KW - neoadjuvant treatment
KW - sensitivity
UR - https://www.scopus.com/pages/publications/85160056452
U2 - 10.1016/j.hpb.2023.04.018
DO - 10.1016/j.hpb.2023.04.018
M3 - Article
C2 - 37211461
SN - 1365-182X
VL - 25
SP - 1161
EP - 1168
JO - HPB
JF - HPB
IS - 10
ER -
SDG 3 Good Health and Well-being