Prognostic predictive value of endoscopic ultrasound findings for invasive ductal carcinomas of pancreatic head.
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.
Nakata
Bunzo
B
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan. bunzo@med.osaka-cu.ac.jp
Nishino
Hiroji
H
Ogawa
Yoshinari
Y
Yokomatsu
Hideaki
H
Kawasaki
Fumihiro
F
Kosaka
Kinshi
K
Wada
Tomoko
T
Suto
Reiko
R
Montani
Ai
A
Hirakawa
Kosei
K
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