Endoscopic Ultrasound–Guided Radiofrequency Ablation for Nonfunctioning Pancreatic Neuroendocrine Tumors

IF 1.1 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy Pub Date : 2026-01-01 Epub Date: 2026-03-26 DOI:10.1016/j.tige.2026.250971

Prahan Chetlur , Daniel Marino , John M. DeWitt , Patrick Joseph Magahis , SriHari Mahadev , Reem Sharaiha , John Lee , Jason Samarasena , Amirali Tavangar , Frances Dang , Stefano Francesco Crinò , Kavel Visrodia , Amrita Sethi , John Doyle , Nirav Thosani , Gregory Haber , Lauren Khanna , Tamas Gonda

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引用次数: 0

Abstract

BACKGROUNDS AND AIMS

Endoscopic ultrasound–guided radiofrequency ablation (EUS-RFA) is a minimally invasive treatment option for nonfunctional pancreatic neuroendocrine tumors (NF-PanNETs). This study aimed to evaluate the efficacy, safety, and predictors of response to EUS-RFA.

METHODS

We conducted a retrospective, multicenter case series across 7 tertiary care centers, including 46 patients with biopsy-proven NF-PanNETs. Demographic, tumor, and procedural data were collected. Technical success was defined as completion of at least 1 radiofrequency ablation (RFA) application. Radiographic response was assessed at ≥10 weeks and ≥3 months using modified Response Evaluation Criteria in Solid Tumors: complete response (CR, 100% reduction), partial response (PR, 30–99%), and no response (NR, <30%). Predictive factors were evaluated using logistic regression. Adverse events were classified per AGREE (Adverse events in GastrRointEstinal Endoscopy) criteria. This study was exempt from institutional review board review after assessment.

RESULTS

Among 46 patients (mean age, 60.9 years; 53% men), most tumors (93.6%) were well-differentiated grade 1, with a mean size of 12.7 mm. Technical success was 100%, with a mean of 2.9 RFA applications. At initial follow-up, CR was achieved in 32.6%, PR in 47.8%, and NR in 19.6%. Of patients with PR/NR (n = 31), 58.1% underwent repeat RFA. At final follow-up (mean, 15.7 months), cumulative response rates were as follows: CR, 60.0%; PR, 31.1%; and NR, 8.9%. Longer probe tips (odds ratio, 5.31; 95% CI, 1.10-33.87) and more RFA applications (odds ratio, 2.61; 95% CI, 1.19-3.9) predicted CR. Adverse events occurred in 15.2% (n = 7), including mild abdominal pain, mild pancreatitis, and 1 grade III bleed.

CONCLUSION

EUS-RFA for NF-PanNETs demonstrates high technical success, durable tumor response, and an acceptable safety profile. Probe length and application number may influence outcomes.

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超声引导下射频消融术治疗无功能胰腺神经内分泌肿瘤

内镜下超声引导射频消融术（EUS-RFA）是治疗无功能胰腺神经内分泌肿瘤（NF-PanNETs）的一种微创治疗选择。本研究旨在评估EUS-RFA的疗效、安全性和预测因素。方法：我们在7个三级医疗中心进行了回顾性的多中心病例系列研究，包括46例活检证实的NF-PanNETs患者。收集了人口统计学、肿瘤和手术数据。技术成功定义为完成至少1次射频消融（RFA）应用。在≥10周和≥3个月时，使用改进的实体瘤反应评价标准评估放射学反应：完全缓解（CR， 100%减少），部分缓解（PR, 30-99%）和无反应（NR, 30%）。采用logistic回归对预测因素进行评估。不良事件按照AGREE（胃肠道内窥镜不良事件）标准分类。本研究在评估后免于机构审查委员会的审查。结果46例患者（平均年龄60.9岁，53%为男性）中，大多数肿瘤（93.6%）为1级好分化，平均大小为12.7 mm。技术成功率为100%，平均有2.9个RFA应用程序。初次随访时，CR为32.6%，PR为47.8%，NR为19.6%。在PR/NR患者（n = 31）中，58.1%的患者接受了重复RFA。最终随访时（平均15.7个月），累积缓解率如下：CR， 60.0%；公关,31.1%;NR为8.9%。较长的探针尖端（优势比为5.31,95% CI为1.10-33.87）和更多的RFA应用（优势比为2.61,95% CI为1.19-3.9）可预测CR。15.2% （n = 7）发生不良事件，包括轻度腹痛、轻度胰腺炎和1例III级出血。结论eus - rfa治疗NF-PanNETs具有很高的技术成功率、持久的肿瘤反应和可接受的安全性。探针长度和应用程序数量可能会影响结果。

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来源期刊

Techniques and Innovations in Gastrointestinal Endoscopy Medicine-Gastroenterology

CiteScore

2.10

自引率

50.00%

发文量