The researchers noted that improved survival related to undergoing EUS in this study is likely due to many factors because EUS is purely a diagnostic imaging modality and carries no direct therapeutic impact. Therefore EUS evaluation may help identify patients who would most likely benefit from undergoing attempts at curative resection. On the other hand, EUS evaluation might help to identify patients with advanced or metastatic pancreatic cancer who would not benefit from curative resection and therefore avoid the morbidity and mortality related to unnecessary surgery.
Researchers also looked at sociodemographic and geographic factors with undergoing EUS evaluation and found in multivariate analysis that younger age, white race, being married, locoregional disease, living in the Midwest region, and more recent year of diagnosis were significant predictors of undergoing EUS. The rate of EUS use in the study patients increased from .6 percent in 1994 to 13.1 percent in 2002. Although EUS evaluation is still performed in a minority of patients with pancreatic cancer, there is an increasing trend in the use of EUS in these patients. This may reflect increasing availability with dissemination of EUS technology from select academic centers to the community.
In an accompanying editorial, Bryan G. Sauer, MD, MSc, and Vanessa M. Shami, MD, Division of Gastroenterology and Hepatology, University of Virginia, Charlottesville, stated that they believe the study "provides further evidence of the value of EUS in pancreatic cancer. Although EUS is not currently used to treat cancer, its association with improved survival is most likely a surrogate for multiple fact
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American Society for Gastrointestinal Endoscopy