Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA

John DeWitt, Menggang Yu, Mohamad A. Al-Haddad, Stuart Sherman, Lee McHenry, Julia K. LeBlanc

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Abstract

Background: The expected survival after the EUS-FNA diagnosis of malignant ascites or liver metastases from pancreatic cancer is not known. Objective: To report overall and 1-year survival in these patients. Design: Retrospective cohort series. Setting: Tertiary referral hospital. Patients: Consecutive subjects with newly diagnosed pancreatic cancer from June 1998 and March 2008 in whom EUS-FNA of the liver or ascitic fluid confirmed hepatic metastases or malignant ascites. Interventions: Calculation of survival after diagnosis by using the Social Security Death Index. Main Outcome Measurements: Survival after EUS-FNA diagnosis of stage IV pancreatic cancer. Results: EUS-FNA identified liver metastases and malignant ascites from primary pancreatic cancer in 75 and 13 patients, respectively, and all 88 died during follow-up. For all 88 patients, the 1-year survival rate and median survival were 3.4% (95% CI, 1.1%-10.4%) and 82 days (range 2-754 days), respectively. The 1-year survival rates for those with liver metastases (4.0% [95% CI, 1.3%-12.1%]) and for those with malignant ascites (0% [95% CI, 0-24.7%]) were similar (P = 1.0). The median survival for patients with liver metastases of 83 days (range 2-754 days) was similar to that for those with malignant ascites (64 days; range 2-153 days) (P = .13). No clinical variable considered predicted survival of more than, less than, or 3 months. Limitations: Retrospective series with variable treatment for malignancy. Conclusions: In patients with pancreatic cancer, identification of malignant ascites or liver metastases by EUS-FNA is associated with a very poor prognosis.

Original languageEnglish (US)
Pages (from-to)260-265
Number of pages6
JournalGastrointestinal endoscopy
Volume71
Issue number2
DOIs
StatePublished - Feb 1 2010

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Pancreatic Neoplasms
Ascites
Neoplasm Metastasis
Survival
Liver
Survival Rate
Social Security
Ascitic Fluid
Tertiary Care Centers

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA. / DeWitt, John; Yu, Menggang; Al-Haddad, Mohamad A.; Sherman, Stuart; McHenry, Lee; LeBlanc, Julia K.

In: Gastrointestinal endoscopy, Vol. 71, No. 2, 01.02.2010, p. 260-265.

Research output: Contribution to journalArticle

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title = "Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA",
abstract = "Background: The expected survival after the EUS-FNA diagnosis of malignant ascites or liver metastases from pancreatic cancer is not known. Objective: To report overall and 1-year survival in these patients. Design: Retrospective cohort series. Setting: Tertiary referral hospital. Patients: Consecutive subjects with newly diagnosed pancreatic cancer from June 1998 and March 2008 in whom EUS-FNA of the liver or ascitic fluid confirmed hepatic metastases or malignant ascites. Interventions: Calculation of survival after diagnosis by using the Social Security Death Index. Main Outcome Measurements: Survival after EUS-FNA diagnosis of stage IV pancreatic cancer. Results: EUS-FNA identified liver metastases and malignant ascites from primary pancreatic cancer in 75 and 13 patients, respectively, and all 88 died during follow-up. For all 88 patients, the 1-year survival rate and median survival were 3.4{\%} (95{\%} CI, 1.1{\%}-10.4{\%}) and 82 days (range 2-754 days), respectively. The 1-year survival rates for those with liver metastases (4.0{\%} [95{\%} CI, 1.3{\%}-12.1{\%}]) and for those with malignant ascites (0{\%} [95{\%} CI, 0-24.7{\%}]) were similar (P = 1.0). The median survival for patients with liver metastases of 83 days (range 2-754 days) was similar to that for those with malignant ascites (64 days; range 2-153 days) (P = .13). No clinical variable considered predicted survival of more than, less than, or 3 months. Limitations: Retrospective series with variable treatment for malignancy. Conclusions: In patients with pancreatic cancer, identification of malignant ascites or liver metastases by EUS-FNA is associated with a very poor prognosis.",
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T1 - Survival in patients with pancreatic cancer after the diagnosis of malignant ascites or liver metastases by EUS-FNA

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AU - Sherman, Stuart

AU - McHenry, Lee

AU - LeBlanc, Julia K.

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N2 - Background: The expected survival after the EUS-FNA diagnosis of malignant ascites or liver metastases from pancreatic cancer is not known. Objective: To report overall and 1-year survival in these patients. Design: Retrospective cohort series. Setting: Tertiary referral hospital. Patients: Consecutive subjects with newly diagnosed pancreatic cancer from June 1998 and March 2008 in whom EUS-FNA of the liver or ascitic fluid confirmed hepatic metastases or malignant ascites. Interventions: Calculation of survival after diagnosis by using the Social Security Death Index. Main Outcome Measurements: Survival after EUS-FNA diagnosis of stage IV pancreatic cancer. Results: EUS-FNA identified liver metastases and malignant ascites from primary pancreatic cancer in 75 and 13 patients, respectively, and all 88 died during follow-up. For all 88 patients, the 1-year survival rate and median survival were 3.4% (95% CI, 1.1%-10.4%) and 82 days (range 2-754 days), respectively. The 1-year survival rates for those with liver metastases (4.0% [95% CI, 1.3%-12.1%]) and for those with malignant ascites (0% [95% CI, 0-24.7%]) were similar (P = 1.0). The median survival for patients with liver metastases of 83 days (range 2-754 days) was similar to that for those with malignant ascites (64 days; range 2-153 days) (P = .13). No clinical variable considered predicted survival of more than, less than, or 3 months. Limitations: Retrospective series with variable treatment for malignancy. Conclusions: In patients with pancreatic cancer, identification of malignant ascites or liver metastases by EUS-FNA is associated with a very poor prognosis.

AB - Background: The expected survival after the EUS-FNA diagnosis of malignant ascites or liver metastases from pancreatic cancer is not known. Objective: To report overall and 1-year survival in these patients. Design: Retrospective cohort series. Setting: Tertiary referral hospital. Patients: Consecutive subjects with newly diagnosed pancreatic cancer from June 1998 and March 2008 in whom EUS-FNA of the liver or ascitic fluid confirmed hepatic metastases or malignant ascites. Interventions: Calculation of survival after diagnosis by using the Social Security Death Index. Main Outcome Measurements: Survival after EUS-FNA diagnosis of stage IV pancreatic cancer. Results: EUS-FNA identified liver metastases and malignant ascites from primary pancreatic cancer in 75 and 13 patients, respectively, and all 88 died during follow-up. For all 88 patients, the 1-year survival rate and median survival were 3.4% (95% CI, 1.1%-10.4%) and 82 days (range 2-754 days), respectively. The 1-year survival rates for those with liver metastases (4.0% [95% CI, 1.3%-12.1%]) and for those with malignant ascites (0% [95% CI, 0-24.7%]) were similar (P = 1.0). The median survival for patients with liver metastases of 83 days (range 2-754 days) was similar to that for those with malignant ascites (64 days; range 2-153 days) (P = .13). No clinical variable considered predicted survival of more than, less than, or 3 months. Limitations: Retrospective series with variable treatment for malignancy. Conclusions: In patients with pancreatic cancer, identification of malignant ascites or liver metastases by EUS-FNA is associated with a very poor prognosis.

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