Endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine tumors and pancreatic cystic neoplasms: a prospective multicenter study.
Endoscopy
; 51(9): 836-842, 2019 09.
Article
in En
| MEDLINE
| ID: mdl-30669161
ABSTRACT
BACKGROUND:
Pancreatic neuroendocrine tumors (NETs) and intraductal pancreatic mucinous neoplasia (IPMN) with worrisome features are surgically managed. Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) has recently been developed. The safety of EUS-RFA was the primary end point of this study, its efficacy the secondary end point.METHODS:
This was a prospective multicenter study that was planned to include 30 patients with a 1-year follow-up with either a NET <â2âcm or a pancreatic cystic neoplasm (PCN), either a branch duct IPMN with worrisome features or a mucinous cystadenoma (MCA). EUS-RFA was performed with an 18G RFA cooling needle.RESULTS:
12 patients had 14 NETs (mean size 13.1âmm, range 10â-â20âmm); 17 patients had cystic tumors (16 IPMNs, 1 MCA; mean size 28âmm, range 9â-â60âmm). Overall three adverse events occurred (10â%), two of these in the first two patients (one pancreatitis, one small-bowel perforation). After these initial patients, modifications in the protocol resulted in a decrease in complications (3.5â%), with one patient having a pancreatic ductal stenosis. Among the 14 NETs, at 1-year follow-up 12 had completely disappeared (86â% tumor resolution), with three patients having a delayed response. Among the 17 PCNs, at 12 months, there were 11 complete disappearances and one diameter that decreased by >â50â% (significant response rate 71â%). All 12 mural nodules showed complete resolution.CONCLUSIONS:
EUS-RFA of pancreatic NETs or PCNs is safe with a 10â% complication rate, which can be decreased by improved prophylaxis for the procedure.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pancreatic Cyst
/
Pancreatic Neoplasms
/
Catheter Ablation
/
Ultrasonography, Interventional
/
Neuroendocrine Tumors
/
Endosonography
Type of study:
Clinical_trials
/
Observational_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Endoscopy
Year:
2019
Type:
Article
Affiliation country:
France