Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA.
BACKGROUND
The expected survival after the EUS-FNA diagnosis of malignant ascites or liver metastases from pancreatic cancer is not known.


OBJECTIVE
To report overall and 1-year survival in these patients.


METHODS
Retrospective cohort series.


METHODS
Tertiary referral hospital.


METHODS
Consecutive subjects with newly diagnosed pancreatic cancer from June 1998 and March 2008 in whom EUS-FNA of the liver or ascitic fluid confirmed hepatic metastases or malignant ascites.


METHODS
Calculation of survival after diagnosis by using the Social Security Death Index.


METHODS
Survival after EUS-FNA diagnosis of stage IV pancreatic cancer.


RESULTS
EUS-FNA identified liver metastases and malignant ascites from primary pancreatic cancer in 75 and 13 patients, respectively, and all 88 died during follow-up. For all 88 patients, the 1-year survival rate and median survival were 3.4% (95% CI, 1.1%-10.4%) and 82 days (range 2-754 days), respectively. The 1-year survival rates for those with liver metastases (4.0% [95% CI, 1.3%-12.1%]) and for those with malignant ascites (0% [95% CI, 0-24.7%]) were similar (P = 1.0). The median survival for patients with liver metastases of 83 days (range 2-754 days) was similar to that for those with malignant ascites (64 days; range 2-153 days) (P = .13). No clinical variable considered predicted survival of more than, less than, or 3 months.


CONCLUSIONS
Retrospective series with variable treatment for malignancy.


CONCLUSIONS
In patients with pancreatic cancer, identification of malignant ascites or liver metastases by EUS-FNA is associated with a very poor prognosis.
DeWitt
John
J
Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA. jodewitt@iupui.edu
Yu
Menggang
M
Al-Haddad
Mohamad A
MA
Sherman
Stuart
S
McHenry
Lee
L
Leblanc
Julia K
JK
D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000401:mortality / Q000473:pathology*; D044963:Biopsy, Fine-Needle / Q000379:methods; D002423:Cause of Death; D015331:Cohort Studies; D004502:Education, Medical, Continuing; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors