Aims Renal cell carcinoma (RCC) is the most common renal cancer in adults. Up to 50% of
patients will develop metastases after nephrectomy with a 5-year survival rate of
10%-15%. Pancreas is an elective site for RCC metastases. Surgery is the first choice
treatment for pancreatic metastases. For not-resectable pancreatic metastases therapeutical
options are limited. Radiofrequency ablation (RFA) has been successfully performed
for the treatment of several not-resectable solid tumours. Previous studies have demonstrated
the feasibility and safety of endoscopic ultrasound-guided radiofrequency ablation
(EUS-RFA) for the treatment of pancreatic lesions. However, there are no data regarding
its use in the treatment of pancreatic metastases from RCC.
To evaluate feasibility and safety of EUS-RFA in the treatment of pancreatic metastases
from RCC.
Methods Single centre prospective study on patients with non-resectable RCC pancreatic metastases
or not amenable to surgery. All patients underwent EUS-RFA with a monopolar, 19 G
RFA needle (Endoscopic UltraSound guided Radiofrequency Ablation electrode; EUSRA)
with a RF power of 30 W.
All patients underwent CT/MRI scan after 24 hours from the procedure. Feasibility
was defined as the possibility of inserting the needle in the lesion and applying
the radiofrequency. Safety was defined by collecting data of any complication occurred
within 3 months of follow-up.
Results From January to August 2019, three patients were enrolled (2 women; mean age 64 ± 19 years).
Overall, four lesions were treated (Mean size 26 ± 17 mm). 3 out of 4 lesions were
located in pancreatic head.
The procedure resulted feasible in 100% of cases. No complications occurred after
the treatment.
The post-procedural imaging showed in all cases the presence of a necrotic area in
the site of treatment.
Conclusions EUS-RFA seems to be a feasible and safe technique for the treatment of not resectable
pancreatic metastases from RCC. Further studies are necessary to determine the efficacy
of this treatment.
