The Role of Endoscopic Ultrasonography in the Diagnosis and Staging of Pancreatic Cancer

SIMPLE SUMMARY: Pancreatic cancer ranks as the seventh leading cause of cancer-related death worldwide. The overall prognosis of pancreatic cancer is poor even in patients with resectable disease. Early detection and accurate diagnosis and staging of pancreatic cancer are essential for developing a treatment strategy, as surgical resection can provide the only potential cure for this disease. Endoscopic ultrasonography is essential in the diagnosis and loco-regional staging of the disease. ABSTRACT: Pancreatic cancer is the fourth leading cause of cancer-related death and the second gastrointestinal cancer-related death in the United States. Early detection and accurate diagnosis and staging of pancreatic cancer are paramount in guiding treatment plans, as surgical resection can provide the only potential cure for this disease. The overall prognosis of pancreatic cancer is poor even in patients with resectable disease. The 5-year survival after surgical resection is ~10% in node-positive disease compared to ~30% in node-negative disease. The advancement of imaging studies and the multidisciplinary approach involving radiologists, gastroenterologists, advanced endoscopists, medical, radiation, and surgical oncologists have a major impact on the management of pancreatic cancer. Endoscopic ultrasonography is essential in the diagnosis by obtaining tissue (FNA or FNB) and in the loco-regional staging of the disease. The advancement in EUS techniques has made this modality a critical adjunct in the management process of pancreatic cancer. In this review article, we provide an overall description of the role of endoscopic ultrasonography in the diagnosis and staging of pancreatic cancer.