title: Prognostic predictive value of endoscopic ultrasound findings for invasive ductal carcinomas of pancreatic head.
abstract: OBJECTIVE
  Accurate preoperative prediction of the prognosis of patients with invasive ductal carcinoma of pancreatic head (pancreatic head cancer) is important for selecting treatment methods. We retrospectively examined the prognostic predictive values of endoscopic ultrasound (EUS) findings for patients with this disease.
  
  
  METHODS
  The subjects were 66 patients with pancreatic head cancer who had undergone EUS. We examined each EUS finding as a possible prognostic predictor, including heterogeneity of internal echo, irregularity of peripheral echo, clarity of boundary echo, dilatation of the main pancreatic duct (MPD), dilatation of the common bile duct, lymph node swelling, vessel invasion, and the presence of ascites, by univariate and multivariate analysis for survival.
  
  
  RESULTS
  Irregular peripheral echo, portal vein invasion, superior mesenteric artery/celiac artery invasion, and the presence of ascites were significant predictors of a poorer prognosis by univariate analysis for survival. In resectable cases, EUS findings of MPD dilatation and portal invasion were significant prognostic predictors by univariate analysis, and MPD dilatation was an independent prognostic predictor by multivariate analysis.
  
  
  CONCLUSIONS
  EUS may be useful for predicting the prognosis of patients with pancreatic head cancer, based on the accuracy it provides in evaluating locoregional spreading.
authors.affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan. bunzo@med.osaka-cu.ac.jp
authors.forename: Bunzo
authors.initials: B
authors.lastname: Nakata
authors.forename: Hiroji
authors.initials: H
authors.lastname: Nishino
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Ogawa
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokomatsu
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Kawasaki
authors.forename: Kinshi
authors.initials: K
authors.lastname: Kosaka
authors.forename: Tomoko
authors.initials: T
authors.lastname: Wada
authors.forename: Reiko
authors.initials: R
authors.lastname: Suto
authors.forename: Ai
authors.initials: A
authors.lastname: Montani
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging*; D019160:Endosonography / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results