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BackgroundThe expected survival after the EUS-FNA diagnosis of malignant ascites or liver metastases from pancreatic cancer is not known. ObjectiveTo report overall and 1-year survival in these patients. DesignRetrospective cohort series. SettingTertiary referral hospital. PatientsConsecutive 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. InterventionsCalculation of survival after diagnosis by using the Social Security Death Index. Main Outcome MeasurementsSurvival after EUS-FNA diagnosis of stage IV pancreatic cancer. ResultsEUS-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. LimitationsRetrospective series with variable treatment for malignancy. ConclusionsIn patients with pancreatic cancer, identification of malignant ascites or liver metastases by EUS-FNA is associated with a very poor prognosis. Indianapolis, Indiana, USA Abbreviation: SEMS, self-expanding metallic stent Current affiliations: Division of Gastroenterology and Hepatology (J.D., M.A.A., S.S., L.M., J.K.L.), Department of Biostatistics (M.Y.), Indiana University Medical Center, Indianapolis, Indiana, USA
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. See CME section; p. 365 If you would like to chat with an author of this article, you may contact Dr. DeWitt at jodewitt@iupui.edu. PII: S0016-5107(09)02425-0 doi:10.1016/j.gie.2009.08.025 © 2010 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved. | ||||||||||||||||||||||