What are the ESMO diagnostic guidelines for pancreatic cancer?

Updated: Oct 02, 2020
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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The European Society of Medical Oncology (ESMO) recommendations for diagnosis of pancreatic cancer include the following [63] :

  • Abdominal ultrasound for the initial examination

  • Endoscopic ultrasound (EUS), contrast-enhanced multi-detector computed tomography (MD-CT) and MRI combined with magnetic resonance cholangiopancreatography (MRCP) for additional evaluation

  • Endoscopic retrograde cholangiopancreatography (ERCP) only to relieve bile duct obstruction

  • ERCP and biliary stenting should be performed only if surgery is not possible

  • Positron emission tomography (PET) is not recommended for diagnosis

  • Biopsy is recommended only when imaging results of a pancreatic lesion are ambiguous; EUS-guided biopsy is preferred and percutaneous sampling should be avoided

  • Metastatic lesions can be biopsied percutaneously under ultrasound or CT guidance or during EUS

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