Long-term follow-up of patients with clinically indeterminate suspicion of pancreatic cancer and normal EUS.
BACKGROUND
EUS often is performed because of a clinical suspicion of pancreatic cancer when the results of other noninvasive diagnostic tests are indeterminate. The aim of this study was to determine the true negative predictive value of a normal EUS in a cohort of patients with an indeterminate suspicion of pancreatic cancer by obtaining long-term follow-up information.


METHODS
Patients referred for EUS of the pancreas for the following indications were identified: elevated carbohydrate-associated antigen (CA 19-9) without other definitive evidence of pancreatic cancer, subtle abnormalities on CT of the pancreas, and unexplained abdominal pain and/or weight loss. Endoscopy procedure reports, as well as inpatient and outpatient records were obtained. In addition, referring physicians, as well as patients, were contacted to acquire adequate follow-up information.


RESULTS
A total of 80 patients were included in the study. Follow-up of at least 6 months was obtained for 76 (95%) patients (mean follow-up 23.9 months). No patient with a normal EUS of the pancreas developed pancreatic cancer or required pancreatic surgery during the follow-up period. One patient in whom a diagnosis of chronic pancreatitis was made by EUS subsequently was found to have pancreatic cancer at surgery.


CONCLUSIONS
A normal EUS of the pancreas in the setting of subtle radiologic findings, serologic abnormalities, and/or nonspecific symptoms definitively rules out the presence of pancreatic cancer.
Catanzaro
Andrew
A
University Hospitals of Cleveland-Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
Richardson
Scott
S
Veloso
Hazel
H
Isenberg
Gerard A
GA
Wong
Richard C k
RC
Sivak
Michael V
MV
Chak
Amitabh
A
D018395:CA-19-9 Antigen / Q000097:blood; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests
D018395:CA-19-9 Antigen