PDF herunterladen
CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(08): E1178-E1185
DOI: 10.1055/a-1479-2199
Original article

Long-term outcome after EUS-guided radiofrequency ablation: Prospective results in pancreatic neuroendocrine tumors and pancreatic cystic neoplasms

Marc Barthet
1   Hopital Nord – Gastroenterology, Marseille, France
,
Marc Giovannini
2   Paoli Calmettes Institute – Endoscopic Unit, Marseille, France
,
Mohamed Gasmi
1   Hopital Nord – Gastroenterology, Marseille, France
,
Nathalie Lesavre
1   Hopital Nord – Gastroenterology, Marseille, France
,
Christian Boustière
3   Hôpital St-Joseph – Gastroenterology, Marseille, France
,
Bertrand Napoleon
4   Centre Chirurgical Lyon Mermoz – Endoscopy Unit, Lyon, France
,
Arthur LaQuiere
3   Hôpital St-Joseph – Gastroenterology, Marseille, France
,
Stephane Koch
5   CHRU Minjoz, Besancon, French Polynesia
,
Geoffroy Vanbiervliet
6   Hôpital de L’Archet 2 – Pôle digestif, Nice France
,
Jean-Michel Gonzalez
1   Hopital Nord – Gastroenterology, Marseille, France
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
    Lizenzen und Reprints

Einführung zu diesem Artikel:

Follow-up after EUS-guided radiofrequency ablation for pancreatic lesions: With more answers, come more questionsEndosc Int Open 2021; 09(08): E1186-E1187
DOI: 10.1055/a-1393-5780

Abstract

Background and study aims Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) for pancreatic neuroendocrine tumors (NETs) and intraductal pancreatic mucinous neoplasia (IPMN) with worrisome features or high-risk stigmata (WF/HRS) has been evaluated in few series with short-term outcomes. This studyʼs primary endpoint was to assess the long-term efficacy of EUS-RFA in patients with NETs or pancreatic cystic neoplasms (PCNs) over at least 3 years.

Patients and methods Twelve patients had 14 NETs with a mean 13.4-mm size (10–20) and 17 patients had a cystic tumor (16 IPMN, 1 MCA) with a 29.1-mm mean size (9–60 were included. They were treated with EUS-guided RFA, evaluated prospectively at 1 year, and followed annually for at least 3 years.

Results The mean duration of follow-up was 42.9 months (36–53). Four patients died during follow-up (17–42 months) from unrelated diseases.

At 1-year follow-up, and 85.7 % complete disappearance was seen in 12 patients with 14 NETs. At the end of follow-up (45.6 months), complete disappearance of tumors was seen in 85.7 % of cases. One case of late liver metastasis occurred in a patient with initial failure of EUS-RFA. At 1-year follow-up, a significant response was seen in 70.5 % of 15 patients with PCNs. At the end of the follow-up, there was a significant response in 66.6 % with no mural nodules. Two cases of distant pancreatic adenocarcinoma unrelated to IPMN occurred.

Conclusions EUS-RFA results for pancreatic NETs or PCNs appear to be stable during 42 months of follow-up.



Publikationsverlauf

Eingereicht: 26. August 2020

Angenommen: 29. Oktober 2020

Artikel online veröffentlicht:
16. Juli 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Kommentar zu diesem Artikel:

Endoscopy International Open – recently publishedEndoscopy 2021; 53(09): 989-989
DOI: 10.1055/a-1519-4791

 

  • References

  • 1 Lee DW, Kim MK, Kim HG. Diagnosis of Pancreatic Neuroendocrine Tumors. Clin Endosc 2017; 50: 537-545
    CrossrefPubMedGoogle Scholar
  • 2 Sachs T, Pratt WB, Callery MP. et al. The incidental asymptomatic pancreatic lesion: nuisance or threat?. J Gastrointest Surg Off J Soc Surg Aliment Tract 2009; 13: 405-415
    CrossrefPubMedGoogle Scholar
  • 3 Strosberg JR, Cheema A, Weber J. et al. Prognostic validity of a novel American Joint Committee on Cancer Staging Classification for pancreatic neuroendocrine tumors. J Clin Oncol Off J Am Soc Clin Oncol 2011; 29: 3044-3049
    CrossrefPubMedGoogle Scholar
  • 4 Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: pancreatic endocrine tumors. Gastroenterology 2008; 135: 1469-1492
    CrossrefPubMedGoogle Scholar
  • 5 Finks JF, Osborne NH, Birkmeyer JD. Trends in hospital volume and operative mortality for high-risk surgery. N Engl J Med 2011; 364: 2128-2137
    CrossrefPubMedGoogle Scholar
  • 6 Lakhtakia S. Therapy of pancreatic neuroendocrine tumors: fine needle intervention including ethanol and radiofrequency ablation. Clin Endosc 2017; 50: 546-551
    CrossrefPubMedGoogle Scholar
  • 7 Chennat J. Current status of endoscopic ultrasound guided ablation techniques. Gastroenterology 2011; 140: 1403-1409
    CrossrefPubMedGoogle Scholar
  • 8 Farrell JJ. Prevalence, diagnosis and management of pancreatic cystic neoplasms: current status and future directions. Gut Liver 2015; 9: 571-589
    CrossrefPubMedGoogle Scholar
  • 9 Tanaka M, Fernández-Del Castillo C, Kamisawa T. et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatol Off J Int Assoc Pancreatol IAP Al 2017; 17: 738-753
    PubMedGoogle Scholar
  • 10 Brugge WR, Lewandrowski K, Lee-Lewandrowski E. et al. Diagnosis of pancreatic cystic neoplasms: a report of the cooperative pancreatic cyst study. Gastroenterology 2004; 126: 1330-1336
    CrossrefPubMedGoogle Scholar
  • 11 Okabayashi T, Kobayashi M, Nishimori I. et al. Clinicopathological features and medical management of intraductal papillary mucinous neoplasms. J Gastroenterol Hepatol 2006; 21: 462-467
    CrossrefPubMedGoogle Scholar
  • 12 Lakhtakia S, Seo D-W. Endoscopic ultrasonography-guided tumor ablation. Dig Endosc Off J Jpn Gastroenterol Endosc Soc 2017; 29: 486-494
    PubMedGoogle Scholar
  • 13 Zacharoulis D, Lazoura O, Rountas C. et al. Experimental animal study of a novel radiofrequency endovascular occlusion device. Am J Surg 2011; 202: 103-109
    CrossrefPubMedGoogle Scholar
  • 14 Sethi A, Ellrichmann M, Dhar S. et al. Endoscopic ultrasound-guided lymph node ablation with a novel radiofrequency ablation probe: feasibility study in an acute porcine model. Endoscopy 2014; 46: 411-415
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Kim HJ, Seo D-W, Hassanuddin A. et al. EUS-guided radiofrequency ablation of the porcine pancreas. Gastrointest Endosc 2012; 76: 1039-1043
    CrossrefPubMedGoogle Scholar
  • 16 Pai M, Habib N, Senturk H. et al. Endoscopic ultrasound guided radiofrequency ablation, for pancreatic cystic neoplasms and neuroendocrine tumors. World J Gastrointest Surg 2015; 7: 52-59
    CrossrefPubMedGoogle Scholar
  • 17 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
    CrossrefPubMedGoogle Scholar
  • 18 Barthet M, Giovannini M, Lesavre N. et al. Endoscopic ultrasound guided radiofrequency ablation for pancreatic neuroendocrine tumors and pancreatic cystic neoplasms: a prospective multicenter study. Endoscopy 2019; 51: 836-842
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 19 Choi JHS, Song TJ, Park DH. et al. Endoscopic ultrasound-guided radiofrequency ablation for management of benign solid pancreatic tumors. Endoscopy 2018; 50: 1099-1104
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 20 Oleinikov KD, Epshtein J, Benson A. et al. Endoscopic ultrasound-guided radiofrequency ablation: a new therapeutic approach for pancreatic neuroendocrine tumors. J Clin Endoc Metab 2019; 104: 2637-47
    CrossrefPubMedGoogle Scholar
  • 21 Jilesen APJ, Van Eijck CHJ, in’t Hof KH. et al. Postoperative complications, In-Hospital mortality and 5-year survival after surgical resection for patients with a pancreatic neuroendocrine tumor: a systematic review. World J Surg 2016; 40: 729-748
    CrossrefPubMedGoogle Scholar
  • 22 Feng Q, Li C, Zhang S. et al. Recurrence and survival after surgery for pancreatic cancer with or without pancreatitis. World J Gastroenterol 2019; 25: 6006-6015
    CrossrefPubMedGoogle Scholar
  • 23 Rimbas M, Horumba M, Rizzatti G. et al. Interventional endoscopic ultrasound for pancreatic neuroendocrine neoplasms. Dig Endosc 2020; 32: 1031-1041
    CrossrefPubMedGoogle Scholar
  • 24 Larghi A, Rizzatti G, Rimbas M. et al. Endoscopic ultrasound-guided radiofrequency ablation as an alternative to surgery for pancreatic neuroendocrine neoplasms: Who should we treat?. Endosc Ultrasound 2019; 8: 220-226
    CrossrefPubMedGoogle Scholar
  • 25 Canakis A, Law R, Baron T. An updated review on ablative treatment of pancreatic cystic lesions. Gastrointest Endosc 2020; 91: 520-526
    CrossrefPubMedGoogle Scholar
  • 26 Slovak R, Ludwig JM, Gettinger SN. et al. Immuno-thermal ablations - boosting the anticancer immune response. J Immunother Cancer 2017; 5: 78
    CrossrefPubMedGoogle Scholar
  • 27 Choi JH, Seo DW, Song TJ. et al. Utility of contrast-enhanced harmonic endoscopic ultrasound for the guidance and monitoring of endoscopic radiofrequency ablation. Gut Liver 2020; 14: 826-832
    CrossrefPubMedGoogle Scholar
  • 28 Sugimoto M, Takagi T, Hikichi T. et al. Efficacy of endoscopic ultrasonography-guided fine needle aspiration for pancreatic neuroendocrine tumor grading. World J Gastroenterol 2015; 21: 8818-8124
    CrossrefPubMedGoogle Scholar
  • 29 Lombardi M, De Lio N, Funel M. et al. Prognostic factors for pancreatic neuroendocrine neoplasms (pNET) and the risk of small non-functional pNET. J Endocrinol Invest 2015; 38: 605-613
    CrossrefPubMedGoogle Scholar
  • 30 Falconi M, Eriksson B, Kaltsas G. et al. ENETS consensus guidelines update for the management of patients with pancreatic functional neuroendocrine tumors and pancreatic non-functional neuroendocrine tumors. Neuroendocrinology 2016; 103: 153-171
    CrossrefPubMedGoogle Scholar
  • 31 Teo RYA, Teo TZ, Tai DWM. et al. Systematic review of current prognostication systems for pancreatic neuroendocrine neoplasms. Surgery 2019; 165: 672-685
    CrossrefPubMedGoogle Scholar
  • 32 Choi JH, Choi YH, Kang J. et al. Natural history of small pancreatic lesions suspected to be non -functioning pancreatic neuroendocrine tumors. Pancreas 2018; 47: 1358-1364
    PubMedGoogle Scholar
  • 33 Uehara H, Nakazaizumi A, Ishikawa O. et al. Development of ductal adenocarcinoma of the pancreas during follow-up of branch duct intraductal papillary mucinous neoplasms of the pancreas. Gut 2008; 57: 1561-1566
    CrossrefPubMedGoogle Scholar
  • 34 Sahora K, Crippa S, Zamboni G. et al. Intraductal papillary mucinous neoplasms of the pancreas with concurrent pancreatic and periampullary neoplasms. Eur J Surg Oncol 2016; 42: 197204
    CrossrefPubMedGoogle Scholar
  • 35 Maire F, Couvelard A, Palazzo L. et al. Pancreatic intraepithelial neoplasia in patients with intraductal papillary mucinous neoplasms: the interest of endoscopic ultrasonography. Pancreas 2013; 42: 1262-1266
    CrossrefPubMedGoogle Scholar
  • 36 Kamata K, Kitano M, Kudo M. et al. Value of EUS in early detection of pancreatic ductal adenocarcinomas in patients with intraductal papillary mucinous neoplasms. Endoscopy 2014; 46: 22-29
    Artikel in Thieme ConnectPubMedGoogle Scholar