TY - JOUR
T1 - Repeat endoscopic ultrasound-guided fine needle aspiration for solid pancreatic lesions at a tertiary referral center will alter the initial inconclusive result
AU - Suzuki, Rei
AU - Lee, Jeffrey H.
AU - Krishna, Somashekar Gopala
AU - Ramireddy, Srinivas
AU - Qiao, Wei
AU - Weston, Brian
AU - Ross, William A.
AU - Bhutani, Manoop S.
PY - 2013/6
Y1 - 2013/6
N2 - Background & Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is indispensable for the diagnosis of solid pancreatic lesions (SPLs). However, initial attempt of EUS-FNA can be inconclusive. We retrospectively evaluated the ability of repeat EUS-FNA at a tertiary referral hospital to obtain a conclusive cytological diagnosis after the initial inconclusive EUS-FNA results at referring facilities. Methods: We identified patients who had undergone EUS-FNA for SPLs and with inconclusive cytological diagnosis at referring facilities. The diagnostic ability of EUS-FNA was defined as the percentage of cases with conclusive cytological diagnoses out of the total included cases in which initial results had been inconclusive. As a secondary outcome, we conducted sub-group analysis to reveal factors which might have assisted conclusive results at the University of Texas MD Anderson Cancer Center (MDA). Results: We found 913 patients who underwent EUS-FNA for SPLs between 2005 and 2011. Among them, we recruited 84 patients who met the above criteria. Repeat EUS-FNA had ability to clarify the diagnosis in 82.1% (69/84). No statistical differences were observed in tumor size (n = 50, 29.8 versus 29.4 mm, P-value = 0.84) and the number of needles passes (n = 40, 4.0 versus 3.4, P-value = 0.1) between outside MDA and MDA. Rapid on-site evaluation was present in less than half of cases outside MDA (n = 33, 42.4 versus 100%, P-value = 0.0001). MDA endosonographers had more years of experience compared to outside MDA (n = 50, 12.9 versus 10 years, P-value = 0.015). Conclusions: A repeat EUS-FNA for SPLs with initial inconclusive diagnosis at a tertiary referral center establishes a diagnosis in the majority of patients.
AB - Background & Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is indispensable for the diagnosis of solid pancreatic lesions (SPLs). However, initial attempt of EUS-FNA can be inconclusive. We retrospectively evaluated the ability of repeat EUS-FNA at a tertiary referral hospital to obtain a conclusive cytological diagnosis after the initial inconclusive EUS-FNA results at referring facilities. Methods: We identified patients who had undergone EUS-FNA for SPLs and with inconclusive cytological diagnosis at referring facilities. The diagnostic ability of EUS-FNA was defined as the percentage of cases with conclusive cytological diagnoses out of the total included cases in which initial results had been inconclusive. As a secondary outcome, we conducted sub-group analysis to reveal factors which might have assisted conclusive results at the University of Texas MD Anderson Cancer Center (MDA). Results: We found 913 patients who underwent EUS-FNA for SPLs between 2005 and 2011. Among them, we recruited 84 patients who met the above criteria. Repeat EUS-FNA had ability to clarify the diagnosis in 82.1% (69/84). No statistical differences were observed in tumor size (n = 50, 29.8 versus 29.4 mm, P-value = 0.84) and the number of needles passes (n = 40, 4.0 versus 3.4, P-value = 0.1) between outside MDA and MDA. Rapid on-site evaluation was present in less than half of cases outside MDA (n = 33, 42.4 versus 100%, P-value = 0.0001). MDA endosonographers had more years of experience compared to outside MDA (n = 50, 12.9 versus 10 years, P-value = 0.015). Conclusions: A repeat EUS-FNA for SPLs with initial inconclusive diagnosis at a tertiary referral center establishes a diagnosis in the majority of patients.
KW - Endoscopic ultrasound
KW - Fine needle aspiration
KW - Pancreatic cancer
KW - Solid pancreatic lesion
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M3 - Article
C2 - 23799217
AN - SCOPUS:84879176966
SN - 1841-8724
VL - 22
SP - 183
EP - 187
JO - Journal of Gastrointestinal and Liver Diseases
JF - Journal of Gastrointestinal and Liver Diseases
IS - 2
ER -