Endoscopy 2019; 51(09): 836-842
DOI: 10.1055/a-0824-7067
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine tumors and pancreatic cystic neoplasms: a prospective multicenter study

Marc Barthet
1  Aix Marseille Université, Service de Gastro-entérologie, Hôpital Nord, Marseille, France
Marc Giovannini
2  Endoscopy Unit, Institut Paoli Calmettes, Marseille, France
Nathalie Lesavre
3  Centre d’Investigation Clinique, Hôpital Nord, Marseille, France
Christian Boustiere
4  Service d’Hépato-gastroentérologie, Hôpital Saint-Joseph, Marseille, France
Bertrand Napoleon
5  Hôpital privé Jean Mermoz, Ramsay Générale de Santé, Lyon, France
Stéphane Koch
6  Department of Gastroenterology, CHRU Minjoz, Besançon, France
Mohamed Gasmi
1  Aix Marseille Université, Service de Gastro-entérologie, Hôpital Nord, Marseille, France
Geoffroy Vanbiervliet
7  Centre Hospitalier Universitaire de Nice, Hôpital L’Archet 2, Nice, France
Jean-Michel Gonzalez
1  Aix Marseille Université, Service de Gastro-entérologie, Hôpital Nord, Marseille, France
› Institutsangaben
TRIAL REGISTRATION: prospective multicenter study NCT02330497 at clinicaltrials.gov
Weitere Informationen


submitted 21. Juni 2018

accepted after revision 12. November 2018

22. Januar 2019 (online)


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 < 2 cm 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 13.1 mm, range 10 – 20 mm); 17 patients had cystic tumors (16 IPMNs, 1 MCA; mean size 28 mm, range 9 – 60 mm). Overall three adverse events occurred (10 %), 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 (3.5 %), with one patient having a pancreatic ductal stenosis. Among the 14 NETs, at 1-year follow-up 12 had completely disappeared (86 % 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 > 50 % (significant response rate 71 %). All 12 mural nodules showed complete resolution.

Conclusions EUS-RFA of pancreatic NETs or PCNs is safe with a 10 % complication rate, which can be decreased by improved prophylaxis for the procedure.