{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:33:32Z","timestamp":1790858012788,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Assessing para\u2010aortic lymph node (PALN) metastasis in solid tumors is crucial for accurate staging. In clinical practice, PALN metastasis is typically diagnosed based on imaging findings; however, the efficacy of endoscopic ultrasound\u2010guided tissue acquisition (EUS\u2010TA) in diagnosing PALN metastasis remains insufficiently understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center, retrospective study included patients who underwent EUS\u2010TA of PALNs and computed tomography (CT). Final diagnoses were based on pathological findings or 12\u2010month imaging follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 167 patients, technical success was achieved in 162 (97.0%). EUS\u2010TA demonstrated a sensitivity, specificity, and accuracy of 85.1% (63\/74), 100% (88\/88), and 93.2% (151\/162), respectively, for PALN metastasis. These results showed significantly higher sensitivity (28.4% vs. 85.1%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and accuracy (64.8% vs. 93.2%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) than those of CT. The accuracy of CT and EUS\u2010TA was 86.8% vs. 89.5% for PALNs measuring &lt;5\u2009mm, 51.5% vs. 92.9% for those measuring 5\u201310\u2009mm, and 84.0% vs. 96.0% for those measuring \u226510\u2009mm, with a significant difference in the 5\u201310\u2009mm category (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Among the 44 patients diagnosed with resectable pancreatic cancer using CT, the final diagnosis confirmed PALN metastasis in 10 (22.7%) patients, and EUS\u2010TA preoperatively identified PALN metastasis in eight (18.2%) patients. EUS\u2010TA significantly reduced unnecessary surgeries compared with CT\u2010only diagnoses (<jats:italic>P<\/jats:italic>\u2009=\u20090.013).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Endoscopic ultrasound\u2010guided tissue acquisition of PALNs offers high diagnostic accuracy and can detect PALN metastasis often missed by CT alone. Integrating EUS\u2010TA into preoperative assessments has the potential to substantially reduce unnecessary surgeries, improve patient outcomes, and plan treatment strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.15009","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:56:01Z","timestamp":1741740961000},"page":"775-786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical significance and efficacy of endoscopic ultrasound\u2010guided tissue acquisition for para\u2010aortic lymph node metastasis"],"prefix":"10.1111","volume":"37","author":[{"given":"Hidenobu","family":"Hara","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Oncology National Cancer Center  Tokyo Japan"},{"name":"Cancer Medicine Jikei University Graduate School of Medicine  Tokyo 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