Abstract
Simple SummaryPancreatic cancer ranks as the seventh leading cause of cancer-related death worldwide. The overall prognosis of pancreatic cancer is poor even in patients with resectable disease. Early detection and accurate diagnosis and staging of pancreatic cancer are essential for developing a treatment strategy, as surgical resection can provide the only potential cure for this disease. Endoscopic ultrasonography is essential in the diagnosis and loco-regional staging of the disease.Pancreatic cancer is the fourth leading cause of cancer-related death and the second gastrointestinal cancer-related death in the United States. Early detection and accurate diagnosis and staging of pancreatic cancer are paramount in guiding treatment plans, as surgical resection can provide the only potential cure for this disease. The overall prognosis of pancreatic cancer is poor even in patients with resectable disease. The 5-year survival after surgical resection is ~10% in node-positive disease compared to ~30% in node-negative disease. The advancement of imaging studies and the multidisciplinary approach involving radiologists, gastroenterologists, advanced endoscopists, medical, radiation, and surgical oncologists have a major impact on the management of pancreatic cancer. Endoscopic ultrasonography is essential in the diagnosis by obtaining tissue (FNA or FNB) and in the loco-regional staging of the disease. The advancement in EUS techniques has made this modality a critical adjunct in the management process of pancreatic cancer. In this review article, we provide an overall description of the role of endoscopic ultrasonography in the diagnosis and staging of pancreatic cancer.
Highlights
Invasive Pancreatic ductal adenocarcinoma (PDAC) arises from precancerous precursor lesions referred to as Pancreatic Intraepithelial Neoplasia (PanIN) that form by metaplasia and proliferation of ductal epithelium
Detection and accurate diagnosis and staging of pancreatic cancer are of paramount importance for planning treatment options
Despite the lack of consensus on the optimal role of Endoscopic ultrasonography (EUS) in the diagnosis and staging of pancreatic cancer among society guidelines, EUS is essential in the diagnosis by tissue acquisition (FNA or FNB) and in the loco-regional staging of the disease
Summary
Pancreatic cancer ranks as the seventh leading cause of cancer-related death worldwide, and the fourth among other cancers in the United States in both men and women [1–3]. In 2022, approximately 62,210 new diagnoses of exocrine pancreatic cancer are predicted in the United States [1]. It is projected that within the two decades, pancreatic cancer incidence rates will continue to increase and surpass colorectal cancer to be the second leading cause of cancer-related deaths in the United States [5]. Most patients present at an advanced stage with overall 5-year survival of approximately 10%. The most important prognostic factor is the tumor stage at diagnosis, supporting the role of early detection and role of screening in pancreatic cancer. IA pancreatic cancer from 2004 to 2016 and improvement in 5-year overall survival for this stage from 44.7% in 2004 to 83.7% in 2012 [7]. Advancement in EUS techniques has made this modality a vital adjunct in the management process of pancreatic cancer
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