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Dig Liver Dis. 2019 Apr 18. pii: S1590-8658(19)30521-3. doi: 10.1016/j.dld.2019.03.015. [Epub ahead of print]

Contrast-enhanced harmonic endoscopic ultrasonography for evaluating the response to chemotherapy in pancreatic cancer.

Author information

1
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-sayama, Japan.
2
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-sayama, Japan. Electronic address: ky11@leto.eonet.ne.jp.
3
Clinical Research Center, Kindai University Hospital, Osaka-sayama, Japan.
4
Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.

Abstract

BACKGROUND AND AIMS:

Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) is used for the diagnosis of pancreatic cancer (PC). Here, we examined the usefulness of CH-EUS for evaluating therapeutic responses in PC.

METHODS:

The study included 23 patients with PC who received chemotherapy. Patients underwent contrast-enhanced computed tomography (CE-CT) and CH-EUS before chemotherapy and at the time of evaluation of the therapeutic response. Patients with a ≧50% reduction in serum carbohydrate antigen 19-9 levels after chemotherapy were defined as "super responders". The incidence of an avascular area in the tumor on CH-EUS after chemotherapy was compared between "super responders" and non-super responders.

RESULTS:

Nine patients were included in the "super responders" group.Tumor reduction rates did not differ significantly between CE-CT and CH-EUS in the "super responders". The appearance of an avascular area was detected in 7 of 9 super responders (77.8%) and in 4 of 14 non-super responders (28.6%), and the difference was significant (P = 0.036). The mean survival time of patients with an avascular area after chemotherapy was longer than that of without an avascular area.

CONCLUSIONS:

Detection of avascular areas by CH-EUS after chemotherapy may predict long-term survival of patients with PC.

KEYWORDS:

Chemotherapy; Contrast-enhanced harmonic endoscopic ultrasonography; Endoscopic ultrasonography; Pancreatic cancer

PMID:
31006543
DOI:
10.1016/j.dld.2019.03.015

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