Laser Ablation of Ampullary Carcinoma

Al, Fowler; Cp, Barham; Bj, Britton; Barr, Hugh

doi:10.1055/s-1999-78

Cited by 9 publications

(3 citation statements)

References 9 publications

(10 reference statements)

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“…Moreover, the longest survival after the first treatment was 57 months. For the local treatment of inoperable AC, Fowler et al treated twelve patients with a median survival of 21 months, and the longest survival after the first treatment was only 36 months [29]. Another study that adopted ERCP-guided radio-frequency ablation as the primary therapy reported a mean OS time of 1,081 (95% CI: 757.8-1404.0) days, with four related adverse cases, including mild pancreatitis, bleeding, and late distal biliary stenosis.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of endoscopic ultrasound-guided iodine-125 seed implantation in inoperable ampullary carcinoma: initial clinical experience

Cui¹,

Han²,

Xiao³

et al. 2022

jcb

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Purpose The objectives of the present study were to evaluate the feasibility, safety, and efficacy of endoscopic ultrasound (EUS)-guided iodine-125 ( 125 I) seed implantation in ampullary carcinoma (AC). Material and methods From January 2011 to June 2020, 13 patients were selected for this retrospective study. Thirteen tumors (27.46 ±12.07 mm) were treated with EUS-guided 125 I seed implantation in 29 sessions. We evaluated the therapeutic efficacy, adverse effects, and overall survival (OS) time. Results Complete response (CR) was observed in one tumor in 6 months. Partial response (PR) was detected in two target tumors in 3 months, seven in 6 months, seven in 9 months, and six in 12 months. Good periods of survival were observed. The median OS was 35 months, 95% confidence interval (95% CI) was 8.97 to 61.03 months. The 1-, 2-, and 5-year OS rates were 100%, 67.5%, and 11.3%, respectively. There were no procedure-related deaths or serious adverse events. Transient abdominal pain (5 cases, 17.2%), abdominal distension and loss of appetite (3 cases, 10.3%), and seed migration (1 case, 3.4%) were observed, respectively. Conclusions In selected patients with inoperable AC, EUS-guided 125 I seed implantation is feasible and safe with favorable local control efficacy and OS.

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Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of endoscopic ultrasound-guided iodine-125 seed implantation in inoperable ampullary carcinoma: initial clinical experience

Cui¹,

Han²,

Xiao³

et al. 2022

jcb

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“…Zu ablativen endoskopischen Verfahren mittels Nd:YAG-Laser, mono- oder bipolarer Koagulation oder Argon-Plasma-Koagulation in der Behandlung von Papillentumoren gibt es bisher nur Fallberichte [76,82,83]. Eine adjuvante Thermoablation nach Papillektomie soll die Rezidivrate senken [84].…”

Section: Technik Der Endoskopischen Papillenresektionunclassified

Endoskopische Papillenresektion: Indikation und Grenzen

Heinzow¹,

Meister

Domagk

2012

Visc Med

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Hintergrund: Adenome der Papilla Vateri sind selten. Prävalenzen von 0,04–0,12% werden beschrieben. Eine maligne Transformation von benignen Adenomen zu Papillenkarzinomen ist möglich und folgt der Adenom-Karzinom-Sequenz. Die meisten Papillenadenome treten sporadisch auf, können jedoch z.B. bei Patienten mit familiärer adenomatöser Polyposis genetisch häufiger vorkommen. Methode: Es erfolgte eine aktuelle PubMed-Recherche zum Thema endoskopische Papillenresektion. Ergebnisse/Schlussfolgerung: Eine endoskopische Papillektomie kann bei Adenomen ohne duktale Infiltration durchgeführt werden, während es in Hinblick auf das papilläre Adenokarzinom noch keinen Konsens gibt. Jedoch konnten neuere Studien zeigen, dass Patienten mit hochgradiger intraepithelialer Neoplasie der Papilla Vateri keine lymphovaskuläre Invasion oder Lymphknotenmetastasen aufweisen, sodass eine endoskopische Papillektomie gerechtfertigt erscheint. Da papilläre Adenome in bis zu 30% der Fälle das Risiko für fokale karzinomatöse Areale beherbergen können, sollte jede Papillektomie «en bloc» durchgeführt werden.

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“…Endoscopic ablation therapies with the Nd:YAG laser and mono-/bipolar thermal ablation have been described [32,33]. Sphincterotomy and biliary stenting are usually performed because fibrosis and scarring can develop subsequently.…”

Section: Managementmentioning

confidence: 99%

Tumors of the ampulla of vater

Jean

Dua

2003

Curr Gastroenterol Rep

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Ampullary tumors are relatively rare, but the occurrence of biliary obstruction early in the disease course facilitates diagnosis. With technologic advances, methods of diagnosis, treatment, and management of ampullary tumors are constantly evolving. However, despite rapid improvements in these areas, preoperative differentiation between adenomas and adenocarcinomas remains difficult. Forcep biopsy specimens can accurately detect the presence or absence of adenomatous changes, but they have a high false-negative rate for adenocarcinoma. Whereas it is generally agreed that all ampullary tumors should be removed or resected, patient selection for the various treatments, including pancreatoduodenectomy, local resection, and endoscopic treatment, remains controversial. Stage of disease, patient characteristics (ie, age and comorbid conditions), and local availability of expertise determine treatment options.

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Laser Ablation of Ampullary Carcinoma

Abstract: The treatment shows promise in selected patients, but conclusions are limited by the small numbers and lack of controls in this study.

Cited by 9 publications

References 9 publications

Feasibility and efficacy of endoscopic ultrasound-guided iodine-125 seed implantation in inoperable ampullary carcinoma: initial clinical experience

Feasibility and efficacy of endoscopic ultrasound-guided iodine-125 seed implantation in inoperable ampullary carcinoma: initial clinical experience

Endoskopische Papillenresektion: Indikation und Grenzen

Tumors of the ampulla of vater

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