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 - the Dutch Pancreatic Cancer Group (DPCG)
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 - Wilmink, Johanna W.
AU - Groot Koerkamp, Bas
AU - van Eijck, Casper H.J.
AU - van Driel, Lydi M.J.W.
N1 - 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.
UR - http://www.scopus.com/inward/record.url?scp=85160056452&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2023.04.018
DO - 10.1016/j.hpb.2023.04.018
M3 - Article
C2 - 37211461
AN - SCOPUS:85160056452
SN - 1365-182X
VL - 25
SP - 1161
EP - 1168
JO - HPB
JF - HPB
IS - 10
ER -
