Endoscopic ultrasound staging is adversely affected by placement of a self-expandable metal stent: fact or fiction?
Pancreas
; 37(4): 396-8, 2008 Nov.
Article
in En
| MEDLINE
| ID: mdl-18953251
ABSTRACT
OBJECTIVES:
Accurate preoperative staging of pancreatic cancer (Pca) is crucial to direct management. There is a perception that endoscopic ultrasound (EUS) staging should be performed before biliary decompression because of artifact caused by self-expandable metal stents (SEMS). Our aim is to determine whether placement of SEMS affects the staging of Pca.METHODS:
Fifty-five patients (35 men; mean age, 67 years) with newly diagnosed Pca staged in the last 5 years and captured prospectively were divided into 2 groups matched by age, sex, and final staging. The staging accuracy of EUS in patients who had a SEMS (n = 28) was compared with patients without a SEMS (n = 27). The gold standard was surgical pathology, or cytologic confirmation of metastatic disease. Multivariate analysis was effected on age, sex, presence of SEMS, and presence of metastasis to assess prediction of staging inaccuracy.RESULTS:
Endoscopic ultrasound correctly staged 14 (52%) of 27 patients in the no-SEMS group and 13 (46%) of 28 in the SEMS group. Logistic regression analysis identified only metastasis as a predictor of inaccuracy in EUS staging.CONCLUSIONS:
Endoscopic ultrasound staging of Pca does not seem to be affected by the presence of a SEMS. The major reason for misstaging in both groups was failure to detect metastatic disease.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatic Neoplasms
/
Biliary Tract Surgical Procedures
/
Stents
/
Artifacts
/
Endosonography
/
Metals
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Pancreas
Journal subject:
GASTROENTEROLOGIA
Year:
2008
Document type:
Article
Affiliation country:
United States
Country of publication:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA