Predicting unresectability in pancreatic cancer patients: the additive effects of CT and endoscopic ultrasound

A standardized method for predicting unresectability in pancreatic cancer has not been defined. We propose a system using CT and endoscopic ultrasound (EUS) to assess patients for unresectable pancreatic cancers. Radiologic and surgical data from 101 patients who underwent exploration/resection for...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2007-01, Vol.11 (1), p.36-42
Main Authors: Yovino, Susannah, Darwin, Peter, Daly, Barry, Garofalo, Michael, Moesinger, Robert
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Endosonography
Female
Humans
Male
Middle Aged
Neoplasm Staging
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Predictive Value of Tests
Survival Rate
Tomography, X-Ray Computed
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Summary:A standardized method for predicting unresectability in pancreatic cancer has not been defined. We propose a system using CT and endoscopic ultrasound (EUS) to assess patients for unresectable pancreatic cancers. Radiologic and surgical data from 101 patients who underwent exploration/resection for pancreatic cancer were reviewed. Chi-squares were used to identify five factors significantly correlated with unresectability, which were incorporated into a scoring system (one point for each factor). The resectability rates were 84, 56, and 10% for patients with scores of 0, 1, and 2, respectively. All four patients with three risk factors for unresectability had unresectable tumors. The most accurate results were achieved in patients evaluated with both CT and EUS. This scoring system stratifies pancreatic cancer patients into three groups: (1) patients with a score of zero (likely to undergo successful resection), (2) patients with a score of one (likely to benefit from laparoscopic staging prior to attempting resection), and (3) patients with a score of two or higher (low probability of successful resection, who may be better served by neoadjuvant therapy).
ISSN:1091-255X
DOI:10.1007/s11605-007-0110-6