title: Impact of endoscopic ultrasound-guided fine-needle aspiration and multidisciplinary approach in the management of abdominal or mediastinal mass.
abstract: BACKGROUND
  Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a useful tool for the diagnosis of suspected abdominal or mediastinal neoplastic lesions.
  
  
  OBJECTIVE
  To evaluate the impact of EUS-FNA and multidisciplinary approach on the diagnostic work-up and therapeutic management of patients with abdominal or mediastinal neoplastic lesions.
  
  
  METHODS
  One hundred and twenty patients (69 men, median age 65 years) with a suspected abdominal or mediastinal neoplastic mass at computed tomography or MRI underwent EUS-FNA. All EUS-FNA findings and clinical data were evaluated by a multidisciplinary team (oncologists, surgeons, and gastroenterologists). EUS-FNA findings were compared with the final diagnosis made by histological evaluation of the surgical specimen or clinical outcome at follow-up.
  
  
  RESULTS
  A correct diagnosis was obtained by EUS-FNA in 96/120 patients (80%), indicating benignancy of the lesion in 21 (18%) cases and confirming malignancy in 75 (62%). On the basis of EUS-FNA findings, chemotherapy was tailored in 57/75 (76%) patients with malignancy whereas the surgical strategy was changed in 21/120 (18%) of patients. Overall, the diagnostic accuracy of EUS-FNA was 85%. A multidisciplinary team approach enabled a correct diagnosis in patients in whom EUS-FNA was nondiagnostic and to identify five cases with false-negative EUS-FNA findings.
  
  
  CONCLUSIONS
  EUS-FNA has a relevant impact on the management of suspected abdominal or mediastinal neoplastic lesions. A multidisciplinary team approach enables to overcome the EUS-FNA methodological limitations. The combination of EUS-FNA and multidisciplinary team approach could help to diagnose and tailor therapeutic options in such patients.
authors.affiliation: aGastroenterology Unit bMedical Oncology Unit, Department of Systems Medicine cDepartment of Surgery, University Tor Vergata, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Del Vecchio Blanco
authors.forename: Manuela
authors.initials: M
authors.lastname: Coppola
authors.forename: Elena
authors.initials: E
authors.lastname: Mannisi
authors.forename: Gerolamo
authors.initials: G
authors.lastname: Bevivino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Formica
authors.forename: Ilaria
authors.initials: I
authors.lastname: Portarena
authors.forename: Samanta
authors.initials: S
authors.lastname: Romeo
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Sileri
authors.forename: Mario
authors.initials: M
authors.lastname: Roselli
authors.forename: Francesco
authors.initials: F
authors.lastname: Pallone
authors.forename: Omero Alessandro
authors.initials: OA
authors.lastname: Paoluzi
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003299:Cooperative Behavior; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D010348:Patient Care Team; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis