Abstract
Patients with unresectable pancreatic cancer have a poor prognosis. The analysis of prognostic factors before treatment may be helpful in determining the best therapeutic strategies. The aim of the PEACE study is to assess the vascularity of pancreatic malignant tumors using contrast-enhanced harmonic EUS (CEH-EUS) and to clarify the prognostic value of tumor vascularity in patients with locally advanced and metastatic pancreatic cancer. Hereby, we present the protocol of a prospective, nonrandomized, single-arm, multicenter study aiming to assess changes in tumor vascularity using CEH-EUS before and 2 months after treatment initiation in patients with unresectable, locally advanced/metastatic pancreatic cancer and to examine the correlation between vascular changes and treatment response, progression-free survival, and overall survival.
Highlights
Pancreatic cancer is one of the most lethal and therapeutically resistant malignancies, with a grim prognosis that is attributed to the late clinical presentation and the relative chemoresistance of the disease.[1]
time‐intensity curve (TIC) analysis is increasingly being recognized as a standardized quantification tool for perfusion characteristics of intra‐abdominal tumors.[15]
Rapid processing of contrast-enhanced harmonic EUS (CEH-EUS) recordings allows trained physicians to objectively analyze otherwise qualitative data provided by contrast enhancement techniques.[16,17]
Summary
Pancreatic cancer is one of the most lethal and therapeutically resistant malignancies, with a grim prognosis that is attributed to the late clinical presentation and the relative chemoresistance of the disease.[1]. TIC analysis is increasingly being recognized as a standardized quantification tool for perfusion characteristics of intra‐abdominal tumors.[15] Rapid processing of CEH-EUS recordings allows trained physicians to objectively analyze otherwise qualitative data provided by contrast enhancement techniques.[16,17] Yamashita et al.[10] performed CE‐EUS on 39 patients with unresectable pancreatic cancer who were scheduled to undergo chemotherapy They showed that both progression‐free survival and overall survival were significantly longer in patients with intratumoral large vessels (P = 0.037 and P = 0.027, respectively) and that a positive vessel sign was an independent factor associated with longer survival.
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