Endoscopy 2018; 50(11): 1099-1104
DOI: 10.1055/a-0583-8387
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided radiofrequency ablation for management of benign solid pancreatic tumors

Jun-Ho Choi
1   Division of Gastroenterology, Department of Internal Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Republic of Korea
,
Dong-Wan Seo
2   Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
,
Tae Jun Song
2   Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
,
Do Hyun Park
2   Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
,
Sang Soo Lee
2   Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
,
Sung Koo Lee
2   Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
,
Myung-Hwan Kim
2   Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
› Institutsangaben
TRIAL REGISTRATION: prospective single arm cohort study KCT0002467 at Korea National Institute of Health (NIH)
Weitere Informationen

Publikationsverlauf

submitted 15. Oktober 2017

accepted after revision 18. Januar 2018

Publikationsdatum:
04. Mai 2018 (online)

Abstract

Background Radiofrequency ablation (RFA) has been increasingly employed in experimental and clinical settings for the management of pancreatic lesions. This study aimed to assess the safety and efficacy of endoscopic ultrasound (EUS)-guided RFA for benign solid pancreatic tumors.

Methods In a single-center, prospective study, 10 patients with benign solid pancreatic tumors underwent EUS-RFA. After the RFA electrode had been inserted into the pancreatic mass, the radiofrequency generator was activated to deliver 50 W of ablation power.

Results Among the 10 patients, 16 sessions of EUS-RFA were successfully performed. Diagnoses included nonfunctioning neuroendocrine tumor (n = 7), solid pseudopapillary neoplasm (n = 2), and insulinoma (n = 1); the median largest diameter of the tumors was 20 mm (range 8 – 28 mm). During follow-up (median 13 months), radiologic complete response was achieved in seven patients. Two adverse events (12.4 %; 1 moderate and 1 mild) occurred.

Conclusions EUS-RFA may be a safe and potentially effective treatment option in selected patients with benign solid pancreatic tumors. Multiple sessions may be required if there is a remnant tumor, and adverse events must be carefully monitored.

 
  • References

  • 1 Song TJ, Seo DW, Lakhtakia S. et al. Initial experience of EUS-guided radiofrequency ablation of unresectable pancreatic cancer. Gastrointest Endosc 2016; 83: 440-443
  • 2 Lakhtakia S, Seo DW. Endoscopic ultrasonography-guided tumor ablation. Dig Endosc 2017; 29: 486-494
  • 3 Lakhtakia S, Ramchandani M, Galasso D. et al. EUS-guided radiofrequency ablation for management of pancreatic insulinoma by using a novel needle electrode (with videos). Gastrointest Endosc 2016; 83: 234-239
  • 4 Kim HJ, Seo DW, Hassanuddin A. et al. EUS-guided radiofrequency ablation of the porcine pancreas. Gastrointest Endosc 2012; 76: 1039-1043
  • 5 Goldberg SN, Mallery S, Gazelle GS. et al. EUS-guided radiofrequency ablation in the pancreas: results in a porcine model. Gastrointest Endosc 1999; 50: 392-401
  • 6 Lee SH, Seo DW, Oh D. et al. Cushing's syndrome managed by endoscopic ultrasound-guided radiofrequency ablation of adrenal gland adenoma. Endoscopy 2017; 49: E1-E2
  • 7 Paik WH, Seo DW. Echoendoscopic ablative therapy for solid pancreatic tumors. J Dig Dis 2017; 18: 135-142
  • 8 Cotton PB, Eisen GM, Aabakken L. et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc 2010; 71: 446-454
  • 9 Keane MG, Bramis K, Pereira SP. et al. Systematic review of novel ablative methods in locally advanced pancreatic cancer. World J Gastroenterol 2014; 20: 2267-2278