Management of non‐functional pancreatic neuroendocrine tumors by endoscopic ultrasound‐guided radiofrequency ablation: Retrospective study in two tertiary centers

Marx, Mariola; Godat, Sébastien; Caillol, Fabrice; Poizat, Flora; Ratone, Jean‐Philippe; Pesenti, Christian; Schoepfer, Alain; Hoibian, Solène; Dahel, Yanis; Giovannini, Marc

doi:10.1111/den.14224

Cited by 19 publications

(17 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, Marx et al [ 31 ] reported two recent trials. The first study included 7 patients with insulinoma, with a complete resolution rate reported in 6 patients (85.7%).…”

Section: Eus-rfa In Pnensmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic ultrasound guided radiofrequency ablation for pancreatic tumors: A critical review focusing on safety, efficacy and controversies

Khoury¹,

Sbeit²,

Napoléon³

2023

World J Gastroenterol

View full text Add to dashboard Cite

The role of endoscopic ultrasound (EUS) in the last two decades has shifted from a diagnostic tool to an important therapeutic tool treating mainly pancreato-biliary disorders. In recent years, its applications for treating pancreatic diseases have broadened, including the implementation of radiofrequency ablation (RFA), which has been traditionally used for treating solid tumors. In this critical in-depth review, we summarized all the papers throughout the literature regarding EUS-RFA for pancreatic neuroendocrine neoplasms, adenocarcinoma, and pancreatic cystic lesions. Overall, for pancreatic neuroendocrine neoplasms we identified 16 papers that reported 96 patients who underwent EUS-RFA, with acceptable adverse events that were rated mild to moderate and a high complete radiological resolution rate of 90%. For pancreatic adenocarcinoma, we identified 8 papers with 121 patients. Adverse events occurred in 13% of patients, mostly rated mild. However, no clear survival benefit was demonstrated. For pancreatic cystic lesions, we identified 4 papers with 38 patients. The adverse events were mostly mild and occurred in 9.1% of patients, and complete or partial radiological resolution of the cysts was reported in 36.8%. Notably, the procedure was technically feasible for most of the patients. Nevertheless, a long road remains before this technique finds its definite place in guidelines due to several controversies. EUS-RFA for pancreatic tumors seems to be safe and effective, especially for pancreatic neuroendocrine neoplasms, but multicenter prospective trials are needed to consider this treatment as a gold standard.

show abstract

“…Additionally, Marx et al [ 31 ] reported two recent trials. The first study included 7 patients with insulinoma, with a complete resolution rate reported in 6 patients (85.7%).…”

Section: Eus-rfa In Pnensmentioning

confidence: 99%

“…Twenty-five patients (92.6%) had a complete radiological resolution at a mean follow-up time of 15.7 mo (range 2-41). Notably, procedure-related AEs occurred in 9 patients[ 31 ] (Table 1 ).…”

Section: Eus-rfa In Pnensmentioning

confidence: 99%

Endoscopic ultrasound guided radiofrequency ablation for pancreatic tumors: A critical review focusing on safety, efficacy and controversies

Khoury¹,

Sbeit²,

Napoléon³

2023

World J Gastroenterol

View full text Add to dashboard Cite

show abstract

“…The mechanism of action of RFA is high‐frequency alternating current, generating high local temperatures that induce coagulative necrosis of the tissues 44 . This treatment approach has been proposed for pancreatic solid lesions, such as PC, NEN, SPN, and other malignant metastatic lesions; 7–21,45,46 however, only the feasibility and safety for treating for PC were assessed. Two ablation devices specifically designed for EUS are mainly used.…”

Section: Summary Of Reviewed Studiesmentioning

confidence: 99%

Endoscopic ablation therapy for the pancreatic neoplasms

Matsumoto

Kato

2022

Digestive Endoscopy

View full text Add to dashboard Cite

Recently, endoscopic ultrasound (EUS)‐guided ablation therapy has been reported as a less invasive therapy for patients with pancreatic neoplasms. Some ablation techniques, including injective ablation (using ethanol or other ablative agents), radiofrequency ablation (RFA), photodynamic therapy, and laser ablation, have been described in the literature. Among these, injective ablation and RFA are more frequently used for treating pancreatic neoplasms. Few studies have evaluated the effectiveness of EUS‐guided ethanol ablation (EUS‐EA) for potentially malignant solid neoplasms (neuroendocrine neoplasms or solid pseudopapillary neoplasms) and have reported a complete response (CR) rate of 60–80%. In addition, the CR rate after EUS‐RFA for these lesions has been reported to be 55–100%, with no additional procedure‐related adverse events (AEs). Regarding the amelioration of the symptoms of an insulinoma, the success rates of both the therapies were found to be excellent. Regarding complete tumor ablation, EUS‐RFA appeared to be superior to EUS‐EA. Although EUS‐RFA has been reported as a safe treatment for pancreatic cancers, its effectiveness remains inadequate. Some studies have examined the effectiveness of EUS‐guided injection ablation therapy for pancreatic cystic neoplasms (PCNs) and have reported CR rates that range from 35% to 79%. Alcohol‐free chemotherapeutic agent ablation appears to be effective, with a low risk of AEs. However, studies on the effectiveness of EUS‐RFA for PCNs are limited. In the future, EUS‐guided ablation therapy could become a more widely used approach for potentially malignant and malignant pancreatic lesions.

show abstract

“…

We thank Dr Rimbas and his colleagues for their interest in our case series on endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) of nonfunctional pancreatic neuroendocrine tumors (NFpNETs) ≤2 cm in 27 patients. 1 Regarding the rate of complications, Rimbas and colleagues questioned whether EUS-RFA treatment was justified in lesions with a size of 9-10 mm. Adverse events occurred during the first nine procedures.

…”

mentioning

confidence: 99%