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Endoscopic Ultrasound-Guided Radiofrequency Ablation: A New Therapeutic Approach for Pancreatic Neuroendocrine Tumors
Ist Teil von
The journal of clinical endocrinology and metabolism, 2019-07, Vol.104 (7), p.2637-2647
Ort / Verlag
Washington, DC: Endocrine Society
Erscheinungsjahr
2019
Link zum Volltext
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
Abstract
Context
Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is rapidly emerging as feasible therapy for patients with pancreatic neuroendocrine tumors (pNETs) in selected cases, as a result of its favorable safety profile.
Objective
To assess the feasibility, safety, and efficacy of EUS-RFA in a cohort of patients with functional and nonfunctional pNETs (NF-pNETs).
Design
Data on pNET patients treated with EUS-RFA between March 2017 and October 2018 at two tertiary centers was retrospectively analyzed.
Results
The cohort included 18 adults (eight women, 10 men), aged 60.4 ± 14.4 years (mean ± SD), seven insulinoma patients, and 11 patients with NF-pNETs. Twenty-seven lesions with a mean diameter of 14.3 ± 7.3 mm (range 4.5 to 30) were treated. Technical success defined as typical postablative changes on a surveillance imaging was achieved in 26 out of 27 lesions. Clinical response with normalization of glucose levels was observed in all (seven of seven) insulinoma cases within 24 hours of treatment. Overall, there were no major complications 48 hours postprocedure. No clinically significant recurrences were observed during mean follow-up of 8.7 ± 4.6 months (range 2 to 21 months).
Conclusions
EUS-guided RFA of pNETs is a minimally invasive, safe, and technically feasible procedure for selected patients.
The initial experience with endoscopic ultrasound-guided radiofrequency ablation for functional and nonfunctional pancreatic neuroendocrine tumors was found to be a safe and feasible therapeutic modality in a selected cohort of patients with small tumors.