Endoscopic ultrasonography and pancreatic cancer

Despite extensive multidisciplinary efforts, the five-year survival rate for all patients with pancreatic adenocarcinoma remains less than 3%. In the last twenty years, endoscopic ultrasound (EUS) has developed into an indispensable tool for the diagnosis and staging of malignant pancreatic lesions. EUS, in combination with helical and multidetector computed tomography scans, is currently 80-90% accurate in determining the tumor TNM stage. EUS fine-needle aspiration obtains diagnostic pathologic samples in approximately 80% of cases, and intraductal ultrasound has augmented the ability to determine the malignant potential of pancreatic strictures. In patients at high-risk for pancreatic malignancy, EUS has been advocated as a screening tool for malignancy. Finally, exciting new developments suggest the potential of EUS as a therapeutic tool, both for the management of pain from pancreatic cancer and as a novel therapeutic-delivery device.