MANAGEMENT OF NONFUNCTIONAL PANCREATIC NEUROENDOCRINE TUMORS BY ENDOSCOPIC ULTRASOUND-GUIDED RADIOFREQUENCY ABLATION: A RETROSPECTIVE STUDY IN TWO TERTIARY CENTERS

Aims Recently, there has been growing interest in investigating endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) for the management of small nonfunctional pancreatic neuroendocrine tumors (nf pNETs). This study presents a preliminary clinical experience, focusing on procedure-related complications.

Methods A bicentric retrospective study was performed that included patients with histologically confirmed nf pNETs≤2 cm who were consecutively treated by EUS-RFA between December 2015 and March 2021 at two tertiary referral centers. Patients with grade 3 lesions, locally advanced or metastatic disease were excluded.

Results In 27 patients (mean age 65.0 years, 52% male), EUS-RFA was successfully performed. All patients had sporadic grade1 lesions (mean size 14.0±4.6 mm, 7% uncinated process, 22% head, 11% body, 19% body/tail junction, and 41% tail). Overall, 9/27 lesions (33%) were cystic. The mean hospital stay was 3.2 days. Complete treatment response was confirmed in 25/27 patients (93%) on cross-sectional imaging (mean follow-up 15.7±12.2 months, range 2-41 months). Two patients had two EUS-RFA sessions until complete necrosis was observed. Periprocedural acute pancreatitis occurred in 4/27 (14.8%), three of them were treated by endoscopic cystogastrostomy (11.1%). One patient underwent secondary surgery. The histopathology of the resected specimen revealed 3 mm of residual tumor tissue.

Conclusions EUS-RFA seems to be a promising treatment strategy for the management of small nf pNETs with excellent efficacy. Further evidence focusing on long-term survival, safety profile and recurrence is needed.

Publication History

Article published online:
14 April 2022