Impact of preoperative endoscopic ultrasound-guided fine needle aspiration on postoperative recurrence and survival in cholangiocarcinoma patients

Abdul Hamid El Chafic, John Dewitt, Julia Kim LeBlanc, Ihab I. El Hajj, Gregory Cote, Michael G. House, Stuart Sherman, Lee McHenry, Henry A. Pitt, Cynthia Johnson, Mehdi Mohamadnejad, Mohammad Al-Haddad

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34 Scopus citations

Abstract

Background and study aim: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is frequently performed for suspected biliary tumors for diagnosis and staging but carries a theoretical risk of needle-track seeding. We aimed to evaluate the impact of preoperative EUS-FNA on long-term outcomes for patients with cholangiocarcinoma (CCA). Patients and methods: In a retrospective single-center study of consecutive patients with CCA with preoperative EUS-FNA, main outcome measures were overall survival and progression-free survival. Results: In 150 patients with confirmed CCA, 61 underwent preoperative FNA. Median overall survival was 18.5 months (95 % confidence limits [CL] 15.4, 25.7): 111 patients died and 39 survived. Of the 150 patients, 119 underwent curative-intent surgical resection, with median progression-free survival of 17.8 months (95 %CL 14.5, 22.8); 89/119 patients had tumor recurrence or died, and 30/119 remained alive and disease-free. On multivariable analysis, overall survival was associated with: undergoing curative-intent surgery (hazard ratio [HR] 5.79, P = 0.001), lack of lymph node involvement (HR 1.89, P = 0.011), younger age (HR 1.51 for every 10 years, P < 0.0015), and small tumor size (HR 1.11 for every 1 cm, P = 0.029). For patients undergoing curative-intent surgery, on multivariable analysis, improved progression-free survival was associated with: lack of lymph node involvement (HR 1.88, P = 0.010), smaller tumor size (HR 1.16 for every 1 cm smaller, P = 0.003), and younger age (HR 1.53 for every 10 years, P < 0.001). Number of needle passes showed no statistically significant impact on overall survival. Conclusion: Preoperative EUS-FNA in patients with CCA does not appear to adversely affect overall or progression-free survival.

Original languageEnglish (US)
Pages (from-to)883-889
Number of pages7
JournalEndoscopy
Volume45
Issue number11
DOIs
StatePublished - Nov 8 2013

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ASJC Scopus subject areas

  • Gastroenterology

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