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  PANCREATOLOGY 

Minerva Medica 2014 April;105(2):121-8

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Endoscopic ultrasonography for diagnosis and staging of pancreatic adenocarcinoma: key messages for clinicians

De Angelis C., Manfrè S. F., Pellicano R.

Department of Gastroenterology and Hepatology Endoscopy and Endosonography Center Molinette Hospital, University of Turin, Turin, Italy


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Endoscopic ultrasound (EUS) is a technique that combines the potential of endoscopy, which enables the visual examination of the mucosal surface of any gastrointestinal (GI) tract, with ultrasonography. Despite diagnostic and therapeutic advance, pancreatic cancer (PC), in particular ductal adenocarcinoma, remains the most deadly of all GI malignancies, with a 5-years survival rate less than 1.8%. Moreover its incidence appears to be increasing and most patients present with advanced cancer either locally or with metastatic spread. Thus, all efforts must be oriented towards the need of an early diagnosis and to reliably identify patients who really can benefit from major surgical interventions. To date the most accurate imaging techniques for PC diagnosis and staging remain contrast-enhanced computed tomography and EUS. While the former should be the first choice in patients with suspected PC, EUS has the highest accuracy in detecting small lesions, in assessing tumor size and lymph nodes involvement. The possibility to obtain samples from suspicious lesions or lymph nodes, by means of EUS-guided fine-needle aspiration, makes this procedure an ideal staging modality for PC. Since an accurate preoperative evaluation is essential to choose the correct management strategy, EUS role is crucial.

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