Biliary stents interfere with endoscopic ultrasound tumor and nodal staging in patients with periampullary cancer.
Dr Fusaroli and colleagues from Italy determined whether this also occurs in patients with pancreatic head cancer.
|Patients with stents were 7 times more likely to be incorrectly tumor staged|
The team studied a consecutive series of patients who were undergoing preoperative endoscopic ultrasound for diagnosis and staging of suspected pancreatic cancer.
The team's main end point was the uni- and multivariate association of biliary stenting with tumor and nodal mis-staging by endoscopic ultrasound.
The surgical tumor and nodal stages were used as gold standards.
The researchers identified a total of 65 patients, of which 19 with biliary stents in situ and 46 without.
Surgical stage tumor 4 was found more frequently in patients with stents, occurring in 53% vs 22% without stents.
The team found that the tumor stage by endoscopic ultrasound was correct in 85% of the patients without biliary stents, and in 47 % of the patients with stents.
The frequency of mis-staging by endoscopic ultrasound was significant only among patients with a biliary stent.
The distribution by endoscopic ultrasound nodal stage did not differ significantly from the surgical nodal -stage distribution in the 2 groups of patients.
According to the multivariate analysis, patients with stents were 7 times more likely to be incorrectly tumor staged.
The research team observed that patients with stents were 4 times more likely to be incorrectly nodal staged than patients without stents.
Dr Fusaroli's team concluded, "The results add support to the recommendation that endoscopic ultrasound staging of pancreatic head neoplasms should be performed prior to stent placement."