Endoscopic Ultrasound-guided Radiofrequency Ablation (EUS-RFA) for Pancreatic Neuroendocrine Tumors (pNETs): a retrospective single center study

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State: Public
Version: After imprimatur
License: Not specified
Serval ID
serval:BIB_A30FA6F7F0C7
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Endoscopic Ultrasound-guided Radiofrequency Ablation (EUS-RFA) for Pancreatic Neuroendocrine Tumors (pNETs): a retrospective single center study
Author(s)
TROSIC-IVANISEVIC T.
Director(s)
SCHOEPFER A.
Codirector(s)
GODAT S.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2019
Language
english
Number of pages
14
Abstract
Background. Pancreatic neuroendocrine tumors (NETs) are typically treated by surgery. The
surgery-associated relevant morbidity and mortality have driven alternative curative
approaches. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is a novel and
promising technique that induces tissue necrosis of localized lesions. We evaluated safety,
technical success and efficacy of EUS-RFA to treat pancreatic NETs.
Method. This is a retrospective single center study. 6 patients were included with a NET < 2
cm between December 2017 and August 2019. EUS-RFA was performed with the EUSRATM 19-
gauge needle from Taewoong® with a power of 50 Watts during maximum 10 seconds in most
cases, except for one patient where we used a power of 30 Watts during 45 seconds according
to the following recommendation of the manufacturer.
Results. Mean size of NETs was 10.7mm (range 7.4-14). One NET was of grade 2 and localized
in the isthmus; five NETs were of grade 1 and localized in the uncinated process (2), in the
isthmus (1) and in the pancreatic body (2). Overall, 3 of the NETs were insulinomas. EUS-RFA
was feasible in all cases (100%). Clinical success was obtained in 5/6 patients (83.3%) without
residual tumor remnant at 12-month imaging follow-up, with a mean number of RFA sessions
of 1.17 per patient. The only patient treated with 30 Watts during 45 seconds developed a
pancreatic fistula that was treated surgically after failure of an endoscopic management. The
3 patients treated for insulinoma did not face any symptoms or hypoglycemia anymore with
an immediate effect following RFA. No significant increase in tumor markers (Chromogranin
A, Neuron-Specific Enolase, C-peptide, proinsulin) was found in any patients after the last RFA
session. Three patients experienced mild post-procedural abdominal pain treated
conservatively.
Conclusion. EUS-RFA management of pancreatic NETs <2cm seems feasible and effective.
Optimal values of RFA power and duration, safety and long-term efficacy need to be
established in further studies including larger patient samples and longer follow-up.
Create date
07/09/2020 13:59
Last modification date
12/02/2021 7:26
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