Technique, safety, and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer

Scopelliti, F.; Pea, Antonio; Conigliaro, Rita; Butturini, Giovanni; Frigerio, Isabella; Regi, Paolo; Giardino, Alessandro; Bertani, Helga; Paini, Marina; Pederzoli, Paolo; Girelli, R.

doi:10.1007/s00464-018-6217-x

Cited by 101 publications

(85 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The remaining one study had technical success of 94 %. Scopelliti et al, who had a 100 % technical success rate, pointed out logistical and anatomical limitations such as scarring from previous radiation or inability to maneuver the stiff probe to the target site [3].…”

Section: Discussionmentioning

confidence: 99%

“…An internal cooling system is sequentially employed to prevent thermogenic damage to surrounding tissue. Postoperative computed tomography (CT) scans were performed to compare the change in size of the enhanced tissue of the tumor to a preoperative CT, as well as to assess for any complications [3].…”

Section: Eus-rfa Techniquementioning

confidence: 99%

“…Of these, six studies showed 100 % pooled clinical success rates with the remaining four reporting clinical success rates ranging from 70 % to 83 %. Many noted a sustained linear regression of the tumor with time when comparing CTs from 7 days post-procedure to CTs at 30 days post-procedure [1,3,10,11]. No significant correlation was found between ablation time, radiofrequency strength, and sustained reduction in tumor burden.…”

Section: Studymentioning

confidence: 99%

“…In cases of unresectable or locally advanced PDAC, EUS-RFA is a developing option with the potential to reduce or downstage the tumor burden. EUS-RFA is potentially a valuable tool for reducing tumor size by inducting coagulative necrosis from direct thermal destruction and/or triggering immunostimulation and antitumor antigens [3,4].…”

mentioning

confidence: 99%

See 3 more Smart Citations

Efficacy of EUS-RFA in pancreatic tumors: Is it ready for prime time? A systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background and study aims Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) can be used in patients with unresectable pancreatic ductal adenocarcinoma (PDAC). We performed a systematic review and meta-analysis to evaluate the efficacy of EUS-RFA in treatment of locally advanced unresectable PDAC and other pancreatic tumors. Patients and methods A comprehensive search was done of multiple electronic databases and conference proceedings including PubMed, EMBASE, Web of Science databases, Google Scholar and manual search of references (from inception through May 2019) to identify the studies reporting use of EUS-RFA for pancreatic lesions. The primary outcome was to evaluate technical and clinical success of the procedure. The secondary outcome was to study overall adverse events (AEs). Results Thirteen studies reporting 165 EUS-RFA procedures on 134 patients were included. Of 134 patients, 27.94 % (38) had unresectable locally advanced PDAC, 40 % (53) had PNETs, 3 % (4) had metastasis to the pancreas and 30 % (41) had other lesions. The pooled technical success rate calculated out of the total number of procedures was 100 % (95 % CI [99.18 – 100], I2 = 0 %). The pooled clinical success rate calculated out of the total number of patients was 91.58 % (95 % CI [82.5 – 98.08], I2 = 21.5 %). The pooled overall AE rates were 14.67 % (95 % CI [4.77 – 27.46], I2 = 56.19 %) out of which abdominal pain was the most common with 9.82 % (95 % CI [3.34 – 18.24], I2 = 23.76 %). Low to moderate heterogeneity was noted. Conclusion EUS-RFA has high technical (100 %) and clinical success (91.5 %) rates. Further multicenter trials are needed to further validate our findings.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Eus-rfa Techniquementioning

confidence: 99%

Section: Studymentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of EUS-RFA in pancreatic tumors: Is it ready for prime time? A systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…RFA treatment exerts therapeutic effect mainly through local thermal ablation to tumor . It has been revealed that perfusion of tumor is an important factor influencing the energy distribution of thermal ablation .…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of enhancement rate by enhanced ultrasound in hepatitis B virus‐positive hepatocellular carcinoma undergoing radiofrequency ablation

Zhou

Cai

Luo

et al. 2019

Asia-Pac J Clncl Oncology

View full text Add to dashboard Cite

Aim:To assess the prognostic significance of enhancement rate (ER) measured by contrastenhanced ultrasonography (CEUS) in patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). Materials and methods:A total of 253 patients with single primary HCC undergoing preoperative CEUS and RFA were enrolled in this study. The ER were evaluated though pretreatment CEUS.After a mean follow-up of 36.8 ± 10.2 months, the correlation of ER measured by CEUS and survival after RFA was analyzed by univariate and multivariate analysis. The optimal cutoff ER value to predict survival was determined using receiver-operating characteristic analysis.Results: Mean follow-up period for all 253 patients was 36.8 ± 10.2 months, 31.2% of patients had died at endpoint. The optimal cutoff ER value predicting survival was 2.2 dB/s. Univariate analysis demonstrated that patients with a high ER level had poorer OS (62.8 months vs 48.8 months, P = 0.02) and recurrence-free survival (RFS = 60.2 months vs 47.4 months, P = 0.03) than patients with a low ER level. ER measured by CEUS also been confirmed as independent risk factor for overall survival (hazard ratio [HR], 1.87; 95% confidence interval [95% CI], 1.21-7.25; P < 0.01) and RFS (HR, 1.67; 95% CI, 1.08-6.21; P < 0.01) in multivariate analysis enrolling gender, BMI, tumor size, antiviral therapy, HBV DNA, histological differentiation, Child-Pugh score and tumor node metastasis (TNM) stage.Conclusions: ER measured by CEUS was a significant predictive factor for survival after RFA for HCC. K E Y W O R D Shepatocellular carcinoma, perfusion, prognosis, radiofrequency ablation is an important factor influencing the energy distribution of thermal ablation. 14,15 Therefore, pretreatment accurate quantification 238

show abstract

EUS‐guided Celiac Plexus Neurolysis for Pain in Pancreatic Cancer

Wyse

Sahai

2021

Clinical Pancreatology for Practising Gastroenterologists and Surgeons

View full text Add to dashboard Cite

Technique, safety, and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer

Abstract: EUS-guided RFA is a feasible and safe minimally invasive procedure for patients with unresectable PDAC. Further studies are warranted to demonstrate the impact of EUS-guided RFA on disease progression and overall survival.

Cited by 101 publications

References 20 publications

Efficacy of EUS-RFA in pancreatic tumors: Is it ready for prime time? A systematic review and meta-analysis

Efficacy of EUS-RFA in pancreatic tumors: Is it ready for prime time? A systematic review and meta-analysis

Prognostic value of enhancement rate by enhanced ultrasound in hepatitis B virus‐positive hepatocellular carcinoma undergoing radiofrequency ablation

EUS‐guided Celiac Plexus Neurolysis for Pain in Pancreatic Cancer

Contact Info

Product

Resources

About