The role of endoscopy in the evaluation and management of patients with suspected pancreatic malignancy

Commentary

Pancreatic cancer is the second most frequent gastrointestinal malignancy with approximately 29,000 new cases occurring annually in the United States. Almost all of these patients will die from the disease, making pancreatic cancer the fourth leading cause of cancer death for both men and women. Since surgical resection of the tumor offers the only chance for a cure, modalities for early diagnosis and accurate preoperative staging have continued to evolve. In this review, Drs. Mallery and Baron discuss the role of new diagnostic modalities including helical or multi-detector CT scan, endoscopic ultrasound (EUS), EUS-guided fine needle aspirate, and MRI, MRCP, and MR angiography. ERCP is now primarily relegated to a therapeutic palliative role in inoperable patients. A clinical management algorithm for patients with suspected pancreatic cancer is provided.