On the first day of the Asian EUS Congress 2017, a session was conducted on the usefulness of EUS technique in staging a tumour. Several eminent doctors spoke regarding this topic during this session.
Dr KM Mohandas from the Tata Memorial Centre, Kolkata was one of the moderators for this session. He said “Over the years things have been changing. There was a role of EUS in staging cancer. Now it has become relative. Its efficiency may vary depending on the type of a cancer and its stages.”
A debate about the essentiality of EUS while staging pancreatic cancer was organised at the Renaissance Convention centre in Powai, Mumbai. The session was moderated by Dr Gayathri Gopalkrishnan, Dr KM Mohandas, Dr YT Lee and Dr Claudio G De Angelis.
Dr Marco Bruno, Director of Endoscopy in the Department of Gastroenterology and Hepatology at the Erasmus Medical Centre in Rotterdam, the Netherlands, spoke in favour of it.
While Dr KM Mohandas spoke against the EUS technique while staging pancreatic cancer.
In his argument Dr Marco Bruno said, “EUS has been shown to complement CT scans in identifying BRPC in a significant proportions of patients with important management consequences. This shows promise to improve the selection for appropriate treatment allocation for patients with pancreatic cancer in order to improve their survival.”
On the other side of the debate, Dr KM Mohandas countered this argument by highlighting the poor outcomes in the use of EUS in staging pancreatic cancer.
He pointed out, saying there is very high amount of metastasis at diagnosis, a high percentage of locally advanced cancers at the time of diagnosis, there is hyper muted cancer and there is substantial mesenchymal involvement.
Dr Angels Gines from the Hospital Clinic, Barcelona, Spain explained why EUS is used less in staging rectal cancer.
“EUS is underutilised in rectal cancer. There is competition with MRI for N and T staging. There is an inability to identify mesorectal fascia,” Dr Gines pointed out.