TY - JOUR
T1 - Safety and efficacy of endoscopic ultrasound-guided radiofrequency ablation for pancreatic insulinoma: A single-center experience
AU - Borrelli De Andreis, Federica
AU - Boskoski, Ivo
AU - Mascagni, Pietro
AU - Schepis, Tommaso
AU - Bianchi, Antonio
AU - Schinzari, Giovanni
AU - Annicchiarico, Brigida Eleonora
AU - Quero, Giuseppe
AU - Tortora, Giampaolo
AU - Alfieri, Sergio
AU - Gasbarrini, Antonio
AU - Costamagna, Guido
AU - Spada, Cristiano
AU - Attili, Fabia
PY - 2023
Y1 - 2023
N2 - Background/objectives: Insulinomas are rare, functioning pancreatic neuroendocrine neoplasms (pNEN), whose gold standard therapy is surgical resection. Endoscopic ultrasound-guided radiofrequency abla-tion (EUS-RFA) is a recent technique that has emerged as a minimally invasive therapeutic option for patients with pancreatic lesions not eligible for surgery. In this study, we aimed to describe a series of patients with unresectable pancreatic insulinoma treated with EUS-RFA.Methods: This is a single-center, retrospective study including all consecutive patients with functioning pancreatic insulinoma undergoing EUS-RFA for surgical unfitness or surgery refusal, between March 2017 and September 2021. Technical success (i.e., complete mass ablation), adverse event rate and severity, clinical and radiologic outcomes (i.e., symptom remission with a normal concentration of blood glucose, and the presence of intralesional necrosis), and post-procedural follow-up were assessed.Results: A total of 10 patients (mean age: 67.1 & PLUSMN; 10.1years; F:M 7:3) were included. The mean size of insulinoma was 11.9 & PLUSMN; 3.3 mm. Technical success and clinical remission were achieved in 100% of pa-tients. Only one (10%) patient was successfully treated with two RFA sessions. Two procedure-related early adverse events occurred, including two (20%) cases of mild abdominal pain. No major complica-tions were observed. The complete radiologic response within 3 months after EUS-RFA was observed in all patients (10 0%). After a median follow-up of 19.5 (range12-59) months, symptom remission and persistent euglycemia were assessed in all the patients.Conclusions: Data from this case series suggest that EUS-RFA is a feasible and safe therapeutic approach for pancreatic insulinomas in patients unwilling or unable to undergo surgery with medium-term efficacy.& COPY; 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.
AB - Background/objectives: Insulinomas are rare, functioning pancreatic neuroendocrine neoplasms (pNEN), whose gold standard therapy is surgical resection. Endoscopic ultrasound-guided radiofrequency abla-tion (EUS-RFA) is a recent technique that has emerged as a minimally invasive therapeutic option for patients with pancreatic lesions not eligible for surgery. In this study, we aimed to describe a series of patients with unresectable pancreatic insulinoma treated with EUS-RFA.Methods: This is a single-center, retrospective study including all consecutive patients with functioning pancreatic insulinoma undergoing EUS-RFA for surgical unfitness or surgery refusal, between March 2017 and September 2021. Technical success (i.e., complete mass ablation), adverse event rate and severity, clinical and radiologic outcomes (i.e., symptom remission with a normal concentration of blood glucose, and the presence of intralesional necrosis), and post-procedural follow-up were assessed.Results: A total of 10 patients (mean age: 67.1 & PLUSMN; 10.1years; F:M 7:3) were included. The mean size of insulinoma was 11.9 & PLUSMN; 3.3 mm. Technical success and clinical remission were achieved in 100% of pa-tients. Only one (10%) patient was successfully treated with two RFA sessions. Two procedure-related early adverse events occurred, including two (20%) cases of mild abdominal pain. No major complica-tions were observed. The complete radiologic response within 3 months after EUS-RFA was observed in all patients (10 0%). After a median follow-up of 19.5 (range12-59) months, symptom remission and persistent euglycemia were assessed in all the patients.Conclusions: Data from this case series suggest that EUS-RFA is a feasible and safe therapeutic approach for pancreatic insulinomas in patients unwilling or unable to undergo surgery with medium-term efficacy.& COPY; 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.
KW - Endoscopic ultrasonography
KW - Insulinomas
KW - Neuroendocrine tumor
KW - Radio-frequency ablation
KW - Endoscopic ultrasonography
KW - Insulinomas
KW - Neuroendocrine tumor
KW - Radio-frequency ablation
UR - http://hdl.handle.net/10807/280163
U2 - 10.1016/j.pan.2023.05.004
DO - 10.1016/j.pan.2023.05.004
M3 - Article
SN - 1424-3903
VL - 23
SP - 543
EP - 549
JO - Pancreatology
JF - Pancreatology
ER -