Endoscopic ultrasound staging is adversely affected by placement of a self-expandable metal stent

Fact or fiction?

Vanessa M. Shami, Anshu Mahajan, Vinay Sundaram, Eric M. Davis, Michelle M. Loch, Michel Kahaleh

Research output: Contribution to journalArticle

Abstract

OBJECTIVES:: Accurate preoperative staging of pancreatic cancer (Pca) is crucial to direct management. There is a perception that endoscopic ultrasound (EUS) staging should be performed before biliary decompression because of artifact caused by self-expandable metal stents (SEMS). Our aim is to determine whether placement of SEMS affects the staging of Pca. METHODS:: Fifty-five patients (35 men; mean age, 67 years) with newly diagnosed Pca staged in the last 5 years and captured prospectively were divided into 2 groups matched by age, sex, and final staging. The staging accuracy of EUS in patients who had a SEMS (n = 28) was compared with patients without a SEMS (n = 27). The gold standard was surgical pathology, or cytologic confirmation of metastatic disease. Multivariate analysis was effected on age, sex, presence of SEMS, and presence of metastasis to assess prediction of staging inaccuracy. RESULTS:: Endoscopic ultrasound correctly staged 14 (52%) of 27 patients in the no-SEMS group and 13 (46%) of 28 in the SEMS group. Logistic regression analysis identified only metastasis as a predictor of inaccuracy in EUS staging. CONCLUSIONS:: Endoscopic ultrasound staging of Pca does not seem to be affected by the presence of a SEMS. The major reason for misstaging in both groups was failure to detect metastatic disease.

Original languageEnglish (US)
Pages (from-to)396-398
Number of pages3
JournalPancreas
Volume37
Issue number4
DOIs
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Pancreatic Neoplasms
Neoplasm Metastasis
Surgical Pathology
Self Expandable Metallic Stents
Decompression
Artifacts
Research Design
Multivariate Analysis
Age Groups
Logistic Models
Regression Analysis

Keywords

  • Endoscopic ultrasound
  • Pancreatic cancer
  • Self-expandable metal biliary stents

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Endoscopic ultrasound staging is adversely affected by placement of a self-expandable metal stent : Fact or fiction? / Shami, Vanessa M.; Mahajan, Anshu; Sundaram, Vinay; Davis, Eric M.; Loch, Michelle M.; Kahaleh, Michel.

In: Pancreas, Vol. 37, No. 4, 11.2008, p. 396-398.

Research output: Contribution to journalArticle

Shami, Vanessa M. ; Mahajan, Anshu ; Sundaram, Vinay ; Davis, Eric M. ; Loch, Michelle M. ; Kahaleh, Michel. / Endoscopic ultrasound staging is adversely affected by placement of a self-expandable metal stent : Fact or fiction?. In: Pancreas. 2008 ; Vol. 37, No. 4. pp. 396-398.
@article{021c0923ae314690b3711e7b246ec3a1,
title = "Endoscopic ultrasound staging is adversely affected by placement of a self-expandable metal stent: Fact or fiction?",
abstract = "OBJECTIVES:: Accurate preoperative staging of pancreatic cancer (Pca) is crucial to direct management. There is a perception that endoscopic ultrasound (EUS) staging should be performed before biliary decompression because of artifact caused by self-expandable metal stents (SEMS). Our aim is to determine whether placement of SEMS affects the staging of Pca. METHODS:: Fifty-five patients (35 men; mean age, 67 years) with newly diagnosed Pca staged in the last 5 years and captured prospectively were divided into 2 groups matched by age, sex, and final staging. The staging accuracy of EUS in patients who had a SEMS (n = 28) was compared with patients without a SEMS (n = 27). The gold standard was surgical pathology, or cytologic confirmation of metastatic disease. Multivariate analysis was effected on age, sex, presence of SEMS, and presence of metastasis to assess prediction of staging inaccuracy. RESULTS:: Endoscopic ultrasound correctly staged 14 (52{\%}) of 27 patients in the no-SEMS group and 13 (46{\%}) of 28 in the SEMS group. Logistic regression analysis identified only metastasis as a predictor of inaccuracy in EUS staging. CONCLUSIONS:: Endoscopic ultrasound staging of Pca does not seem to be affected by the presence of a SEMS. The major reason for misstaging in both groups was failure to detect metastatic disease.",
keywords = "Endoscopic ultrasound, Pancreatic cancer, Self-expandable metal biliary stents",
author = "Shami, {Vanessa M.} and Anshu Mahajan and Vinay Sundaram and Davis, {Eric M.} and Loch, {Michelle M.} and Michel Kahaleh",
year = "2008",
month = "11",
doi = "10.1097/MPA.0b013e3181800d2e",
language = "English (US)",
volume = "37",
pages = "396--398",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Endoscopic ultrasound staging is adversely affected by placement of a self-expandable metal stent

T2 - Fact or fiction?

AU - Shami, Vanessa M.

AU - Mahajan, Anshu

AU - Sundaram, Vinay

AU - Davis, Eric M.

AU - Loch, Michelle M.

AU - Kahaleh, Michel

PY - 2008/11

Y1 - 2008/11

N2 - OBJECTIVES:: Accurate preoperative staging of pancreatic cancer (Pca) is crucial to direct management. There is a perception that endoscopic ultrasound (EUS) staging should be performed before biliary decompression because of artifact caused by self-expandable metal stents (SEMS). Our aim is to determine whether placement of SEMS affects the staging of Pca. METHODS:: Fifty-five patients (35 men; mean age, 67 years) with newly diagnosed Pca staged in the last 5 years and captured prospectively were divided into 2 groups matched by age, sex, and final staging. The staging accuracy of EUS in patients who had a SEMS (n = 28) was compared with patients without a SEMS (n = 27). The gold standard was surgical pathology, or cytologic confirmation of metastatic disease. Multivariate analysis was effected on age, sex, presence of SEMS, and presence of metastasis to assess prediction of staging inaccuracy. RESULTS:: Endoscopic ultrasound correctly staged 14 (52%) of 27 patients in the no-SEMS group and 13 (46%) of 28 in the SEMS group. Logistic regression analysis identified only metastasis as a predictor of inaccuracy in EUS staging. CONCLUSIONS:: Endoscopic ultrasound staging of Pca does not seem to be affected by the presence of a SEMS. The major reason for misstaging in both groups was failure to detect metastatic disease.

AB - OBJECTIVES:: Accurate preoperative staging of pancreatic cancer (Pca) is crucial to direct management. There is a perception that endoscopic ultrasound (EUS) staging should be performed before biliary decompression because of artifact caused by self-expandable metal stents (SEMS). Our aim is to determine whether placement of SEMS affects the staging of Pca. METHODS:: Fifty-five patients (35 men; mean age, 67 years) with newly diagnosed Pca staged in the last 5 years and captured prospectively were divided into 2 groups matched by age, sex, and final staging. The staging accuracy of EUS in patients who had a SEMS (n = 28) was compared with patients without a SEMS (n = 27). The gold standard was surgical pathology, or cytologic confirmation of metastatic disease. Multivariate analysis was effected on age, sex, presence of SEMS, and presence of metastasis to assess prediction of staging inaccuracy. RESULTS:: Endoscopic ultrasound correctly staged 14 (52%) of 27 patients in the no-SEMS group and 13 (46%) of 28 in the SEMS group. Logistic regression analysis identified only metastasis as a predictor of inaccuracy in EUS staging. CONCLUSIONS:: Endoscopic ultrasound staging of Pca does not seem to be affected by the presence of a SEMS. The major reason for misstaging in both groups was failure to detect metastatic disease.

KW - Endoscopic ultrasound

KW - Pancreatic cancer

KW - Self-expandable metal biliary stents

UR - http://www.scopus.com/inward/record.url?scp=58149143064&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58149143064&partnerID=8YFLogxK

U2 - 10.1097/MPA.0b013e3181800d2e

DO - 10.1097/MPA.0b013e3181800d2e

M3 - Article

VL - 37

SP - 396

EP - 398

JO - Pancreas

JF - Pancreas

SN - 0885-3177

IS - 4

ER -