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

Oleinikov, Kira; Dancour, Alain; Epshtein, Julia; Benson, Ariel A.; Mazeh, Haggi; Tal, Ilanit; Matalon, Shay; Benbassat, Carlos; Livovsky, Dan M.; Goldin, Eran; Gross, David J.; Jacob, Harold; Grozinsky‐Glasberg, Simona

doi:10.1210/jc.2019-00282

Cited by 99 publications

(108 citation statements)

References 41 publications

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“…Delayed AEs (> 7 days) were reported in two studies including three patients [1,11]. In the Oleinokov study, two patients developed mild pancreatitis between 7 and 10 days post-procedure, which resolved on the second or third day of the hospitalization.…”

Section: Meta-analysis Outcomesmentioning

confidence: 97%

“…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%

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

et al. 2020

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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.

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Section: Meta-analysis Outcomesmentioning

confidence: 97%

Section: Studymentioning

confidence: 99%

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

et al. 2020

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“…Among the 11 NF‐PanNENs patients, eight showed complete radiological response, one no response, while in the remaining two patients response was not assessed. Two cases of mild pancreatitis requiring brief hospitalization occurred after EUS‐RFA (two and three days post RFA) in patients with NF‐PanNENs 63…”

Section: Eus‐guided Radiofrequency Ablationmentioning

confidence: 99%

“…50–62 A total of 30 F‐PanNENs (exclusively insulinomas) in 25 patients were successfully treated using either the Habib RFA probe or the EUSRA needle, without occurrence of AEs 50–58. Three case series have explored the utility of EUS‐RFA with the EUSRA needle in NF‐PanNENs 57,58,63. In the first published case series of seven patients,57 13 sessions of EUS‐RFA were employed achieving a complete response in five patients.…”

Section: Eus‐guided Radiofrequency Ablationmentioning

confidence: 99%

“…A third case series included 11 patients with 18 lesions, who were either unfit for surgery or preferred RFA over other treatment modalities 63. RFA was applied in three to 10 cycles of 5–12 s with a power setting between 10 and 50 W. Among the patients with NF‐PanNENs, eight patients had G1 tumors, two had G3 tumors, while in the remaining one the EUS‐FNA sample was deemed inadequate to assess tumor grading.…”

Section: Eus‐guided Radiofrequency Ablationmentioning

confidence: 99%

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Interventional endoscopic ultrasound for pancreatic neuroendocrine neoplasms

Rimbaș

Horumba

Rizzatti

et al. 2020

Digestive Endoscopy

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The proximity of the endoscopic ultrasound (EUS) transducer to the pancreas and the possibility to place needles or other accessories into a target located adjacent to the wall of the GI tract have encouraged researchers to develop various EUS‐guided local treatments directed towards pancreatic neuroendocrine neoplasms (PanNENs). The use of pre‐operative EUS‐guided tattooing or fiducial marker placement to facilitate intraoperative tumor localization has proven effective in reducing operative time of laparoscopic surgeries. To reduce the mortality and morbidity rates of surgical resection, which is presently the mainstay treatment of PanNENs. EUS‐guided loco‐regional treatments, such as injection of alcohol and radiofrequency ablation have been proposed and results are hitherto promising. The present paper summarizes currently available data in the field of EUS‐guided interventions to pancreatic neuroendocrine tumors, as well as possible future applications.

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How to do EUS‐guided Radiofrequency Ablation of Pancreatic Neuroendocrine Tumors

Barthet,

Gasmi,

Gonzalez

2021

Atlas of Endoscopic Ultrasonography

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

Cited by 99 publications

References 41 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

Interventional endoscopic ultrasound for pancreatic neuroendocrine neoplasms

How to do EUS‐guided Radiofrequency Ablation of Pancreatic Neuroendocrine Tumors

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