Preoperative Endoscopic Ultrasound Fine Needle Aspiration Versus Upfront Surgery in Resectable Pancreatic Cancer: A Systematic Review and Meta-analysis of …
A Alghamdi, V Palmieri, N Alotaibi… - Journal of the …, 2022 - academic.oup.com
Journal of the Canadian Association of Gastroenterology, 2022•academic.oup.com
Abstract Background and Aim Endoscopic ultrasound-guided fine needle aspiration (EUS-
FNA) is the standard of care in advanced pancreatic cancer. Its role in resectable disease,
however, is controversial. This meta-analysis aims to ascertain the clinical outcomes of
patients with resectable pancreatic cancer undergoing preoperative EUS-FNA compared to
those going directly to surgery. Methods A literature search was performed from 1996 to
April 2019 using MEDLINE, EMBASE, and ISI Web of Knowledge for studies comparing …
FNA) is the standard of care in advanced pancreatic cancer. Its role in resectable disease,
however, is controversial. This meta-analysis aims to ascertain the clinical outcomes of
patients with resectable pancreatic cancer undergoing preoperative EUS-FNA compared to
those going directly to surgery. Methods A literature search was performed from 1996 to
April 2019 using MEDLINE, EMBASE, and ISI Web of Knowledge for studies comparing …
Background and Aim
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the standard of care in advanced pancreatic cancer. Its role in resectable disease, however, is controversial. This meta-analysis aims to ascertain the clinical outcomes of patients with resectable pancreatic cancer undergoing preoperative EUS-FNA compared to those going directly to surgery.
Methods
A literature search was performed from 1996 to April 2019 using MEDLINE, EMBASE, and ISI Web of Knowledge for studies comparing preoperative EUS-FNA to EUS without FNA in resectable pancreatic cancer for clinical outcomes. The primary outcome is overall survival (OS). Secondary outcomes include cancer-free survival, tumor recurrence and peritoneal carcinomatosis, and post-FNA-pancreatitis rate.
Results
Six retrospective studies were included. Preoperative EUS-FNA had better OS than the non-FNA group (WMD, 4.40 months [0.02 to 8.78]). Cancer-free survival did not differ significantly between the two groups (WMD, 2.08 months [−2.22 to 6.38]). EUS with FNA was not associated with increased rates of tumor recurrence or peritoneal carcinomatosis.
Conclusion
Preoperative EUS-FNA in resectable pancreatic cancer may be associated with significantly greater OS when compared to the non-FNA group, with no significant difference in the rates of tumor recurrence or peritoneal seeding. Important limitations of our meta-analysis include the lack of prospective controlled data, which are unlikely to emerge given feasible constraints.
Oxford University Press以上显示的是最相近的搜索结果。 查看全部搜索结果