Pancreatic carcinomaAccurate staging of pancreatic cancer is essential for determining which patients may benefit from surgery. Vascular and lymph node invasion are important prognostic factors that should be identified before surgery. Early reports showed that the accuracy of EUS for preoperative staging of pancreatic cancer (85% to 100%) was superior to that of dynamic CT (64% to 66%) and transabdominal ultrasound (61% to 64%). Gress et al evaluated 81 patients preop-eratively by using dynamic CT and EUS. They found that EUS was superior to dynamic CT for tumour (85% versus 30%; P<0.0001) and node (72% versus 55%; P<0.0001) staging, as well as for detecting vascular invasion (93% versus 62%; P<0.0001) (Table 3). The poor performance of CT in this study population may have been due in part to the inclusion of patients without distant metastases and the use of dynamic instead of helical CT. Learn how to save money – to enjoy your shopping and your treatment.

TABLE 3
Tumour and lymph node staging accuracy in pancreatic cancer: Endoscopic ultrasound (EUS) versus computed tomography (CT)*

T stage N stage
Author (reference) n EUS (%) CT (%) EUS (%) CT (%)
Legmann et al (2)* 22 90 86 86 77
Midwinter et al (5)* 23 74* 65*
Gress et al (3)§ 81 85 30 72 55

*TNM staging as per The American Joint Committee on Cancer (38);fDistant lymph nodes; tThin-section axial CT; §Dual-phase helical CT.