Endoscopic Ultrasound-Guided Radiofrequency (EUS-RFA) and Ethanol Ablation (EUS-EA) of Pancreatic Neuroendocrine Tumors and Adenocarcinoma: A Prospective Multicenter Study
Rattachement africain : Égypte, gb, ro, sa. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Aims EUS-RFA and EUS-EA are emerging novel methods for managing non-functioning and functioning pNET and adenocarcinoma in the pancreas. We aim to assess the safety profile, feasibility, and outcomes of EUS-RFA and EUS-EA of focal pancreatic masses. Methods This prospective study included 27 patients, 15 males and 12 females, with a mean age of 36.38 years. EUS-RFA was carried out in 13 patients; 11 had pancreatic insulinoma, and 2 had advanced pancreatic adenocarcinoma. The mean size of the masses was 20.6 mm, while that of the insulinomas was 17.4 mm. The median of the needle passes was 3, with a range of 1 to 6 passes. RFA was conducted using 19G EUSRA needles from Taewoong Co., Ltd., South Korea. No minor or major complications were observed. EUS-EA was carried out in 14 patients, all of whom had pancreatic insulinoma. The mean size of the masses was 15.3 mm. The median of the needle passes was 2, with a range of 1 to 3 passes. We used 19G and 22G echo tip FNA needles from Cook Company, USA. The mean duration of follow-up was 12.4 months. There was mild to moderate chronic pancreatitis in 4 patients in the EUS-EA group; all were relieved by conservative therapy, and no hospital admission was required. No early or late significant complications were reported in the EUS-RFA group. [ 1 ] Results There was a complete clinical cure of 10 out of 11 (91%) patients with pancreatic insulinoma who underwent EUS-RFA. However, one patient required three sessions, and two patients required two sessions of EUS-RFA. The 11 th patient with insulinoma showed poor response after the first session, then partial response after the second session of EUS-RFA. The size of the two masses with advanced adenocarcinoma was decreased, but no downstaging of the masses was achieved. There was a complete clinical cure of 8 out of 14 (57%) patients with pancreatic insulinoma who underwent EUS-EA. No clinical cure was observed in 4 patients; 3 underwent major surgery, and the 4 th one underwent EUS-RFA. The last two patients showed partial clinical response with decreased frequency, duration, and severity of hypoglycemic attacks. They were managed by diet regulation; no major surgery was needed. Conclusions EUS-RFA and EUS-EA can potentially treat lesions and control symptoms. EUS-RFA is a more promising and safer technique for managing functioning insulinomas. However, it can not downstage PDAC patients. EUS-EA seems less efficient, with more adverse events than EUS-RFA. Publication History Article published online: 15 April 2024 © 2024. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Endoscopic Ultrasound-Guided Radiofrequency (EUS-RFA) and Ethanol Ablation (EUS-EA) of Pancreatic Neuroendocrine Tumors and Adenocarcinoma: A Prospective Multicenter Study
- Date Crossref
- 01/04/2024
- Éditeur
- Georg Thieme Verlag KG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Mansoura University Mansoura University, Égypte (code pays fourni par la source)Université ou école supérieure
-
Research Institute of Ophthalmology Égypte (code pays fourni par la source)Structure de recherche
-
Theodor Bilharz Research Institute Department of Hepatology and Gastroenterology Cairo, Égypte (code pays fourni par la source)Structure de recherche
-
Obour Institutes Égypte (code pays fourni par la source)Université ou école supérieure
-
Stockport NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
-
Victor Babeș University of Medicine and Pharmacy Timișoara Department of Gastroenterology pays non établi dans la noticeUniversité ou école supérieure
-
Spitalul Clinic Dr. Victor Babes pays non établi dans la noticeÉtablissement de santé
-
King Abdulaziz Hospital pays non établi dans la noticeÉtablissement de santé
-
Kasr Al-Aini School of Medicine Division of Gastroenterology Cairo, Égypte (pays nommé en fin d’affiliation)Université ou école supérieure
-
Ahmed Maher Teaching Hospital Department of Gastroenterology Cairo, Égypte (pays nommé en fin d’affiliation)Établissement de santé
-
Gehan st Mansoura, Égypte (pays nommé en fin d’affiliation)Institution
-
Division of Gastroenterology and Hepatology Égypte (pays nommé en fin d’affiliation)Institution
Mansoura University (Mansoura University, Égypte), Research Institute of Ophthalmology (Égypte) et Department of Hepatology and Gastroenterology — Theodor Bilharz Research Institute (Cairo, Égypte), avec 9 autres affiliations. Pays d’affiliation : Égypte.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.