Diagnostic accuracy of endoscopic ultrasonography-guided tissue acquisition prior to resection of pancreatic carcinoma: a nationwide analysis.

Autor: Quispel R; Department of Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Delft, the Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, the Netherlands. Electronic address: r.quispel@rdgg.nl., Schutz HM; Department of Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Delft, the Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, the Netherlands., Keultjes AWP; Department of Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Delft, the Netherlands., Erler NS; Department of Biostatistics, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, the Netherlands., Janssen QP; Department of Surgery, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, the Netherlands., van Hooft JE; Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, the Netherlands., Venneman NG; Department of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, the Netherlands., Honkoop P; Department of Gastroenterology and Hepatology, Albert Schweitzer Ziekenhuis, Dordrecht, the Netherlands., Hol L; Department of Gastroenterology and Hepatology, Maasstad Ziekenhuis, Rotterdam, the Netherlands., Scheffer RC; Department of Gastroenterology and Hepatology, Jeroen Bosch Ziekenhuis, 's Hertogenbosch, the Netherlands., Bisseling TM; Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, the Netherlands., Voermans RP; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Amsterdam, the Netherlands., Vleggaar FP; Department of Gastroenterology and Hepatology, Utrecht University Medical Centre, Utrecht, the Netherlands., Schwartz MP; Department of Gastroenterology and Hepatology, Meander Medical Centre, Amersfoort, the Netherlands., Verdonk RC; Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, the Netherlands., Hoge CV; Department of Gastroenterology and Hepatology, Maastricht University Medical Centre, Maastricht, the Netherlands., Kuiken SD; Department of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands., Curvers WL; Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands., van Vilsteren FGI; Department of Gastroenterology and Hepatology, University Medical Centre Groningen, Groningen, the Netherlands., Poen AC; Department of Gastroenterology and Hepatology, Isala Hospital, Zwolle, the Netherlands., Spanier MB; Department of Gastroenterology and Hepatology, Rijnstate Hospital, Arnhem, the Netherlands., Bruggink AH; Dutch Pathology Registry (PALGA), the Netherlands., Smedts FM; Department of Pathology, Reinier de Graaf Gasthuis, Delft, the Netherlands., van Velthuysen MF; Department of Pathology, Erasmus University Medical Centre, Rotterdam, the Netherlands., van Eijck CH; Department of Surgery, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, the Netherlands., Besselink MG; Department of Surgery, Amsterdam University Medical Centre, Amsterdam, the Netherlands., Veldt BJ; Department of Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Delft, the Netherlands., Koerkamp BG; Department of Surgery, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, the Netherlands., van Driel LMJW; Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, the Netherlands., Bruno MJ; Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Jazyk: angličtina
Zdroj: HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2023 Nov; Vol. 25 (11), pp. 1438-1445. Date of Electronic Publication: 2023 Jul 23.
DOI: 10.1016/j.hpb.2023.07.900
Abstrakt: Introduction: Endoscopic ultrasonography guided tissue acquisition (EUS + TA) is used to provide a tissue diagnosis in patients with suspected pancreatic cancer. Key performance indicators (KPI) for these procedures are rate of adequate sample (RAS) and sensitivity for malignancy (SFM).
Aim: assess practice variation regarding KPI of EUS + TA prior to resection of pancreatic carcinoma in the Netherlands.
Patients and Methods: Results of all EUS + TA prior to resection of pancreatic carcinoma from 2014-2018, were extracted from the national Dutch Pathology Registry (PALGA). Pathology reports were classified as: insufficient for analysis (b1), benign (b2), atypia (b3), neoplastic other (b4), suspected malignant (b5), and malignant (b6). RAS was defined as the proportion of EUS procedures yielding specimen sufficient for analysis. SFM was calculated using a strict definition (malignant only, SFM-b6), and a broader definition (SFM-b5+6).
Results: 691 out of 1638 resected patients (42%) underwent preoperative EUS + TA. RAS was 95% (range 89-100%), SFM-b6 was 44% (20-77%), and SFM-b5+6 was 65% (53-90%). All centers met the performance target RAS>85%. Only 9 out of 17 met the performance target SFM-b5+6 > 85%.
Conclusion: This nationwide study detected significant practice variation regarding KPI of EUS + TA procedures prior to surgical resection of pancreatic carcinoma. Therefore, quality improvement of EUS + TA is indicated.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE