Endoscopic ultrasound-guided radiofrequency ablation of pancreatic neuroendocrine tumors: a single-center experience

Aims Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an emerging and minimally invasive technique that seems promising for treatment of pancreatic neuroendocrine tumors (pNETs). This study presents a single-center experience in treating pNETs≤2 cm with EUS-RFA focusing on its safety and efficacy.

Methods 316 patients diagnosed with pNETs based on EUS-guided fine needle biopsy between 2011 and 2024 were retrospectively identified. 37 of these patients with 38 histologically proven G1 pNETs, who were treated with EUS-RFA and followed-up at least 6 months, were included in the analysis.

Results 37 patients (14 males; mean age 52 years) were included, accounting for 38 lesions (mean lesion size 12,6mm; range 6-20): 31 non-functioning pNETs (82%) and 7 pancreatic insulinomas (18%). All lesions were treated with EUS-RFA (mean total ablation time for lesion 35±25s; range 7-105s; mean session number 1.44; range 1-4). All patients with insulinomas remained asymptomatic. 83% of all patients showed complete lesion regression (no contrast enhancement in CT or/and EUS) and 17% showed partial response (mean follow-up 23.7±15.9 months; range 6-56 months). Regarding safety, most patients (83%) presented no adverse events (AEs), one (2%) developed non-severe acute pancreatitis, five (13%) had mild abdominal pain and one patient (2%) was reported with local hematoma treated conservatively. No severe AEs occured.

Conclusions EUS-RFA is effective and safe for treatment of functional and nonfunctional pNETs. However, further studies focusing on long-term response and recurrence are needed.

Publication History

Article published online:
27 March 2025