scholarly journals Endoscopic Ultrasound-Guided Radiofrequency Ablation: A New Therapeutic Approach for Pancreatic Neuroendocrine Tumors

2019 ◽  
Vol 104 (7) ◽  
pp. 2637-2647 ◽  
Author(s):  
Kira Oleinikov ◽  
Alain Dancour ◽  
Julia Epshtein ◽  
Ariel Benson ◽  
Haggi Mazeh ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Therapeutic Approach ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ultrasound Guided

scholarly journals Endoscopic ultrasound-guided radiofrequency ablation of pancreatic neuroendocrine tumors: a case series

2020 ◽  
Vol 08 (12) ◽  
pp. E1754-E1758
Author(s):  
Germana de Nucci ◽  
Nicola Imperatore ◽  
Enzo Domenico Mandelli ◽  
Franca di Nuovo ◽  
Corrado d’Urbano ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Therapeutic Option ◽  
Case Series ◽  
Pancreatic Head ◽  
Complete Disappearance ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ultrasound Guided ◽  
Effective Therapeutic Option

Abstract Background and study aims Surgery is the considered the therapeutic cornerstone for pancreatic neuroendocrine tumors (P-NETs), although burdened by high risk of significant adverse events. Recently, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been described for P-NETs. We aimed to evaluate the effectiveness and safety of EUS-RFA for treatment of P-NETs. Patients and methods We prospectively included all consecutive patients with P-NET ≤ 20 mm who were treated with EUS-RFA and were followed-up for at least 12 months. Results Ten patients (5 males, mean age 78.6 years, mean body mass index 28.2) with 11 P-NETs (mean size 14.5 mm; range 9 – 20 mm) localized in the pancreatic head (3 lesions), pancreatic body (5 lesions), and tail (3 lesions) underwent complete EUS ablation with one session of RFA. Complete ablation of P-NET was reached using a single-session RFA with a mean of 2.3 treatment applications per session. At both 6 – and 12-months computed tomography scans, all the patients had complete disappearance of lesions with radiological normalization. Regarding safety, only two cases of mild abdominal pain were recorded in two subjects with pancreatic head lesion, which were effectively treated with analgesics. The mean duration of hospital stay was 4 days (range 3 – 7 days). Conclusions EUS-RFA is effective and safe in treating P-NETs. It may be considered an effective therapeutic option in the treatment of small P-NETs independently from their functional status.

scholarly journals Endoscopic ultrasound-guided radiofrequency ablation of pancreatic neuroendocrine tumors: a systematic review of the literature

2020 ◽  
Vol 08 (12) ◽  
pp. E1759-E1764
Author(s):  
Nicola Imperatore ◽  
Germana de Nucci ◽  
Enzo Domenico Mandelli ◽  
Annalisa de Leone ◽  
Francesco Paolo Zito ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Literature Review ◽  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Predictive Value ◽  
Case Reports ◽  
Response To Treatment ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ultrasound Guided ◽  
Response Group

Abstract Background and study aims Surgery is the mainstay therapy for pancreatic neuroendocrine tumors (P-NETs), but it is associated with significant adverse events (AEs). In recent years, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been described for treating P-NETs. We performed a systematic literature review aimed at exploring the feasibility, effectiveness, and safety of EUS-RFA in treatment of P-NETs. Methods The literature review was performed in PubMed/MEDLINE, EMBASE, and SCOPUS to identify all case reports of EUS-RFA for treatment of P-NETs. Results Sixyt-one patients (males 49.2 %, mean age 64.5 years) and 73 tumors (mean size 16 mm, insulinomas 30.1 %) treated with EUS-RFA were included from 12 studies. The overall effectiveness of EUS-RFA was 96 % (75 % – 100 %) without differences between functional vs. non-functional P-NETs (P = 0.3) and without relevant issues about safety (mild AEs 13.7 %). While tumor location was not predictive for incomplete/non-response to EUS-RFA, greater tumor dimensions predicted treatment failure (21.8 ± 4.71 mm in the non-response group vs 15.07 ± 7.34 mm in the response group, P = 0.048). At ROC analysis, a P-NET size cut-off value ≤18 mm predicted response to treatment, with a sensitivity of 80 % (95 % CI 28.4 % – 99.5 %), a specificity of 78.6 % (95 % CI 63.2 % – 89.7 %), a positive predictive value of 97.1 % (95 % CI 84.7 % – 99.9 %) and a negative predictive value of 30.8 % (95 % CI 9.1 % – 61.4 %), with an area under the curve of 0.81 (95 % CI 0.67 – 0.95). Conclusions EUS-RFA is safe and effective for treating P-NETs. It may be reasonable to consider EUS-RFA for small P-NETs, irrespective of the functional status.

Endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine tumors and pancreatic cystic neoplasms: a prospective multicenter study

Endoscopy ◽  
2019 ◽  
Vol 51 (09) ◽  
pp. 836-842 ◽  
Author(s):  
Marc Barthet ◽  
Marc Giovannini ◽  
Nathalie Lesavre ◽  
Christian Boustiere ◽  
Bertrand Napoleon ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Multicenter Study ◽  
Cystic Neoplasm ◽  
Pancreatic Neuroendocrine Tumors ◽  
Prospective Multicenter Study ◽  
End Point ◽  
Mean Size

Abstract Background Pancreatic neuroendocrine tumors (NETs) and intraductal pancreatic mucinous neoplasia (IPMN) with worrisome features are surgically managed. Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) has recently been developed. The safety of EUS-RFA was the primary end point of this study, its efficacy the secondary end point. Methods This was a prospective multicenter study that was planned to include 30 patients with a 1-year follow-up with either a NET < 2 cm or a pancreatic cystic neoplasm (PCN), either a branch duct IPMN with worrisome features or a mucinous cystadenoma (MCA). EUS-RFA was performed with an 18G RFA cooling needle. Results 12 patients had 14 NETs (mean size 13.1 mm, range 10 – 20 mm); 17 patients had cystic tumors (16 IPMNs, 1 MCA; mean size 28 mm, range 9 – 60 mm). Overall three adverse events occurred (10 %), two of these in the first two patients (one pancreatitis, one small-bowel perforation). After these initial patients, modifications in the protocol resulted in a decrease in complications (3.5 %), with one patient having a pancreatic ductal stenosis. Among the 14 NETs, at 1-year follow-up 12 had completely disappeared (86 % tumor resolution), with three patients having a delayed response. Among the 17 PCNs, at 12 months, there were 11 complete disappearances and one diameter that decreased by > 50 % (significant response rate 71 %). All 12 mural nodules showed complete resolution. Conclusions EUS-RFA of pancreatic NETs or PCNs is safe with a 10 % complication rate, which can be decreased by improved prophylaxis for the procedure.

Su1376 Evaluation of the Shark Coreâ® Needle for Endoscopic Ultrasound-Guided Fine Needle Aspirations of Pancreatic Neuroendocrine Tumors

2017 ◽  
Vol 85 (5) ◽  
pp. AB356
Author(s):  
Benjamin Witt ◽  
Rachel Factor ◽  
Barbara Chadwick ◽  
Justin E. Caron ◽  
Ali Siddiqui ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ultrasound Guided ◽  
Fine Needle
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