Ampullary Radiofrequency Ablation For The Treatment Of Residual And Recurrence Neoplasia After Endoscopic Papillectomy: Report Of A Tertiary Center

Dahel, Yanis; Giovannini, Marc; Pesenti, Christian; Ratone, JP; Hoibian, Solène; Caillol, Fabrice

doi:10.1055/s-0041-1724809

Cited by 1 publication

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“…1 ). A total of 12 were utilized for qualitative synthesis and seven for quantitative synthesis, totaling 124 patients 12 13 14 15 23 24 25 . Five studies were excluded from the quantitative analysis due to duplicate data ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thus, some studies have reported that EP alone may achieve curative resection in cases of Tis and T1a carcinoma without lymphatic invasion 30 31 32 . Moreover, despite the absence of studies evaluating the use of RFA for neuroendocrine tumors (NET), the study published by Dahel et al included a single patient with this neoplasm 24 . There are no available studies assessing its use for duodenal NET; however, two meta-analyses published in 2023 demonstrated positive outcomes in the use of RFA for pancreatic NET 33 34 .…”

Section: Resultsmentioning

confidence: 99%

“…[30][31][32] Moreover, despite the absence of studies evaluating the use of RFA for neuroendocrine tumors (NET), the study published by Dahel et al included a single patient with this neoplasm. [24] There are no available studies 6 assessing its use for duodenal NET; however, two meta-analyses published in 2023 demonstrated positive outcomes in the use of RFA for pancreatic NET. [33,34] Additionally, the rate of AEs was higher than evidenced in studies that analyze RFA for malignant biliary strictures.…”

Section: Discussionmentioning

confidence: 99%

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Radiofrequency ablation for ampullary neoplasia with intraductal extension after endoscopic papillectomy: Systematic review and meta-analysis

Landim,

de Moura,

Hirsch

et al. 2023

Endosc Int Open

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Background/Aims: Noninvasive ampullary neoplasms may be removed by surgery or endoscopy. However, given the morbidity and mortality associated with surgery, endoscopic papillectomy (EP) is the preferred approach. Radiofrequency ablation (RFA) after EP has emerged as a promising alternative therapy to avoid surgery after incomplete EP. Our goal was to evaluate the efficacy and safety of RFA for residual or recurrent lesions with intraductal extension after endoscopic papillectomy. Methods: The inclusion criteria include clinical trials, cohort studies, and case series evaluating patients with residual or recurrent lesions with intraductal extension after EP treated with RFA. Case reports, duplicated data, follow-up period of fewer than 10 months were excluded. The metanalysis evaluated adverse events, surgical conversion rate, clinical success and recurrence. Results: Seven studies were selected, totaling 124 patients. RFA was associated with a clinical success rate of 75.7% (95% CI 65.0-88.0%; I2=23.484) in a mean follow-up period greater than 10 months. However, the biliary stricture rate was 22.2% (95% CI 12.1-28.4%; I2=61.030), 14.3% of pancreatitis (95% CI 8.8-22.3%; I2<0.001), 7.0% of cholangitis (95% CI 3.3-14.5%; I2<0.001), 4.0% of bleeding (95% CI 1.7-9.3%; I2<0.001) and recurrence of 24.3% (95% CI 16.0-35.0%; I2=23.484). Conclusions: RFA is feasible and appears to be effective for managing residual or recurrent lesions with intraductal extension after EP. However, long-term follow-up and high-quality studies are required to confirm our findings.

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