A meta-analysis on the efficacy of endoscopic ultrasonography for treatment of pancreatic cancer

Abstract

Objective:

This study aimed to systematically evaluate the efficacy and safety of Endoscopic Ultrasonography (EUS) for the treatment of pancreatic cancer.

Methods:

The PubMed, Embase, Web of Science, and Google Scholar databases were searched from the inception of the databases to June 2022. RevMan 5.3.0 software was utilized for data analysis. In total, 13 self-descriptive studies, which enrolled 382 patients, were finally included.

Results

It was revealed that EUS for the treatment of pancreatic cancer exhibited a lower incidence of adverse reactions (Relative Risk Ration [RR = 0.23], 95 % Confidence interval [95 % CI 0.23-0.23]), a higher success rate (RR = 0.90, 95 % CI 0.90-0.90), and a low failure rate (RR = 0.06, 95 % CI 0.06-0.06). Moreover, EUS-guided Celiac Plexus Neurolysis (EUS-CPN) not only significantly relieved pancreatic cancer patients’ pain (RR = 0.83, 95 % CI 0.83-0.83), but also significantly eliminated pain in some patients (RR = 0.09, 95 % CI 0.09-0.09). The effects of EUS on pancreatic cancer treatment were satisfactory, and few adverse reactions were found.

Conclusion:

Owing to the restricted sample size in this meta-analysis, primarily consisting of descriptive studies, it was imperative to conduct more rigorously designed, multi-center, long-term follow-up, larger sample, and Randomized Controlled Trials (RCTs) to validate the findings.

Keywords:
Endoscopic ultrasonography (EUS); Pancreatic cancer; EUS-guided radiofrequency ablation; Randomized controlled trials; Meta-analysis

HIGHLIGHTS

EUS-guided treatment for pancreatic cancer had fewer adverse reactions and a higher success rate.

The direct injection of absolute ethanol into the abdominal ganglion exerted the best pain relief effects.

US-guided Celiac Plexus Neurolysis (EUS-CPN) relieved and eliminated pain significantly.