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Endoscopic Ultrasound-Fine Needle Aspiration Predicts 5-year Survival in Pancreatic Endocrine Tumours

OAK BROOK, Ill -- November 23, 2009 -- In the November issue of GIE: Gastrointestinal Endoscopy, a study examining endoscopic ultrasound (EUS) demonstrated the accuracy of EUS-fine needle aspiration (FNA) in diagnosing and determining the malignant behaviour of pancreatic endocrine tumours.

In the first study, researchers from the Institute Paoli-Calmettes, Marseilles, France, set out to determine the value of EUS-FNA for the diagnosis of PETs and for classifying the underlying malignant potential of these tumours based on the proposed World Health Organization (WHO) classification.

Although EUS-FNA is often used for diagnosing PET, there are no data on its accuracy in determining the malignant potential of PETs and in applying the WHO classification.

The single-center, retrospective cohort study involved 86 patients who had been diagnosed with PETs and submitted to an EUS-FNA from January 1999 to August 2008.

Overall, in 90% of patients in this study, PET was diagnosed with EUS-FNA. The sensitivity did not vary with tumour size, type, location, or the presence of hormonal secretion.

Of 86 patients, 35% were submitted to surgical resection. There was a fair correlation between the WHO classification obtained by EUS-FNA and that obtained by surgery in the 24 patients who had records on both procedures available.

All 10 patients classified as having an endocrine carcinoma by EUS-FNA had the diagnosis confirmed by surgery. The five-year survival rates were 100% for endocrine tumours, 68% for well-differentiated endocrine carcinomas, and 30% for poorly differentiated endocrine carcinomas.

The researchers concluded that EUS-FNA is a safe and highly accurate technique for diagnosing PET and that it is possible to determine the potential malignant behaviour of a PET in specimens obtained by EUS-FNA by applying the WHO classification.

EUS-FNA findings predict 5-year survival in patients with PET and this may help to better guide the therapeutic approach for these patients.

SOURCE: American Society for Gastrointestinal Endoscopy

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