Endoscopic ultrasound in pancreatic cancer: innovative applications beyond the basics

Pancreatic ductal adenocarcinoma (PDA) is rarely curable at the time of diagnosis as most patients present with either locally advanced or metastatic disease. It has been estimated that less than 20% of patients with newly diagnosed pancreatic cancer have surgically resectable disease, and approximately 30% of patients present with locally advanced disease (1). Locally advanced disease is defined as unresectable pancreatic cancer without evidence of distant metastatic disease. Of the patients who are eligible for surgical resection, most will relapse and experience a median survival of 23 months (2). Even in patients with margin-negative resection, the risk of both local and systemic recurrence is high, and in the cases without adjuvant therapy, the 5-year survival is 10–13% (3,4)