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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(10): E1243-E1251
DOI: 10.1055/a-1221-5012
Review

Efficacy of EUS-RFA in pancreatic tumors: Is it ready for prime time? A systematic review and meta-analysis

Amaninder Dhaliwal
1   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Sindhura Kolli
2   Department of Bariatrics, NYU Langone Medical Center, New York, New York, United States
,
Banreet Singhg Dhindsa
3   Department of Internal Medicine, University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United States
,
Jacqueline Choa
3   Department of Internal Medicine, University of Nevada Las Vegas School of Medicine, Las Vegas, Nevada, United States
,
Harmeet Singh Mashiana
1   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Daryl Ramai
4   Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, United States
,
Saurabh Chandan
1   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Neil Bhogal
1   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Harlan Sayles
5   Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Ishfaq Bhat
1   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Shailender Singh
1   Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States
,
Douglas G. Adler
6   University of Utah School of Medicine, Gastroenterology and Hepatology, Salt Lake City, Utah, United States
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Abstract

Background and study aims Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) can be used in patients with unresectable pancreatic ductal adenocarcinoma (PDAC). We performed a systematic review and meta-analysis to evaluate the efficacy of EUS-RFA in treatment of locally advanced unresectable PDAC and other pancreatic tumors.

Patients and methods A comprehensive search was done of multiple electronic databases and conference proceedings including PubMed, EMBASE, Web of Science databases, Google Scholar and manual search of references (from inception through May 2019) to identify the studies reporting use of EUS-RFA for pancreatic lesions. The primary outcome was to evaluate technical and clinical success of the procedure. The secondary outcome was to study overall adverse events (AEs).

Results Thirteen studies reporting 165 EUS-RFA procedures on 134 patients were included. Of 134 patients, 27.94 % (38) had unresectable locally advanced PDAC, 40 % (53) had PNETs, 3 % (4) had metastasis to the pancreas and 30 % (41) had other lesions. The pooled technical success rate calculated out of the total number of procedures was 100 % (95 % CI [99.18 – 100], I2 = 0 %). The pooled clinical success rate calculated out of the total number of patients was 91.58 % (95 % CI [82.5 – 98.08], I2 = 21.5 %). The pooled overall AE rates were 14.67 % (95 % CI [4.77 – 27.46], I2 = 56.19 %) out of which abdominal pain was the most common with 9.82 % (95 % CI [3.34 – 18.24], I2 = 23.76 %). Low to moderate heterogeneity was noted.

Conclusion EUS-RFA has high technical (100 %) and clinical success (91.5 %) rates. Further multicenter trials are needed to further validate our findings.



Publication History

Received: 16 April 2020

Accepted: 12 June 2020

Article published online:
22 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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