Solid Pancreatic Lesions Visualized on Endoscopic Ultrasound in the Gulf Council Countries: An International Multicenter Study

Aims The assessment of pancreatic lesions has become a common indication for endoscopic ultrasound (EUS). The increased utilization of sampling techniques and the expertise of trained endoscopists have contributed significantly to the heightened identification of both solid and cystic pancreatic lesions. In the west, the prevalence of solid lesions detected via EUS is well-documented, with adenocarcinomas being the most common type. However, specific data for the Gulf Council Countries (GCC) of solid pancreatic lesions evaluated and/or biopsied by EUS is currently lacking. This study aims to determine the prevalence of solid pancreatic lesions detected by EUS in tertiary centers across the GCC and to assess the clinicopathological characteristics of these lesions in the region.

Methods Retrospective international multicenter analysis of solid pancreatic lesions assessed by EUS. Preliminary data of lesions identified from Jan 2022-Dec 2022 were included. Epidemiological and clinicopathological factors were analyzed.

Results A total of 193 patients (74 [38.3%] female, mean age 60 years [SD: 13]) at 8 tertiary care centers (KSA: 3, UAE: 3, Kuwait: 2) were included. Of these patients, 28% (54/193) were smokers, while 35.2% (68/193) were non-smokers. Smoking status was unknown in 36.8% (71/193). While 51.8% (100/193) denied alcohol intake , 5.7% (11/193) reported alcohol intake and the remaining 42.5% (82/193) had unknown alcohol intake status. Mean BMI was 26.5 (SD=6.2). Only 3.6% (7/193) had positive family history of pancreatic cancer in a first-degree relative; 66.3% (128/193) denied family history, and the remaining 30.1% (58/193) had unknown family history. Regarding symptoms, most common symptoms were abdominal pain (67.4%, 130/193), weight loss (50.8%, 98/193) and jaundice (32.6%, 63/193). Only 15.5% (30/193) reported no symptoms at time of EUS. On EUS, mean lesion size was 40.5mm x 34.6 mm (SD 18.4). Lesions were most frequently located in the head of pancreas (59.6%, 115/193), body (30%, 58/193), tail (5.2%, 10/193) and neck (5.2%, 10/193). Most lesions had no cystic component (75.6%, 146/193). Pancreatic duct was normal in 34.2% (66/193), with duct dilation being the most commonly reported abnormality (24.3%, 47/193). Most common diagnosis was adenocarcinoma (128/193, 66.3%), followed by neuroendocrine tumor (21/193, 10.8%), benign tissue (19/193, 9.8%), other diagnoses (10/193, 5.2%). The remaining 15/193 (7.7%) diagnoses were unavailable. Mean age of patients diagnosed with adenocarcinoma was 63 years (SD 13).

Conclusions This is the first international multicenter data reporting epidemiologic data of solid pancreatic lesions evaluated by EUS in the GCC. Adenocarcinoma is the most frequent cause of solid pancreatic masses, with a median age of 63 years at diagnosis which is slightly lower than the worldwide reported age of 70 years. Further regional data and studies are needed to help develop targeted screening and management strategies for affected individuals. [1] [2]

Publication History

Article published online:
15 April 2024

• References

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