Endoscopy 2019; 51(04): S57
DOI: 10.1055/s-0039-1681339
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: EUS therapeutic pancreas South Hall 2B
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ULTRASOUND GUIDED RADIOFREQUENCY ABLATION FOR NEUROENDOCRINE TUMORS: A SINGLE CENTER CASE SERIES

G de Nucci
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
,
ED Mandelli
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
,
D Redaelli
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
,
D Morganti
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
,
N Imperatore
2   Gastroenterology Unit, Federico II University, Naples, Italy
,
R Reati
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
,
G Manes
1   Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese-Milano, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Radiofrequency ablation (RFA) has been used to treat abdominal tumors. Pancreatic tissue is particularly sensitive to external insults, including heat, leading to slower adoption of RFA for pancreatic tumors.RFA provided survival benefit in unresectable pancreatic cancer patients. EUS-guided RFA (EUS-RFA) in the pancreas of animals is feasible, with an acceptable incidence of pancreatitis suggesting its use for managing small pancreatic neuroendocrine tumors (PNETs), above all the functions pNets such as insulinomas. The EUS-RFA system consists of a 19-gauge needle electrode, generator, and internal cooling system (EUSRA system Taewoong). The needle electrode is passed under EUS guidance into the target lesion avoiding pancreatic/bile duct. The echogenic needle tip is positioned at the far end inside the lesion. The energy delivery (10 watt) was applied when the needle tip of the electrode was visualized within the margin of lesion on EUS.

Methods:

We enrolled prospectively ten patients (6 males, mean age 78,6 years) with a diagnosis of pNets obtained with a Ct scan and an eus (with a fine needle biopsy to confirm the nature of the lesions) and all of these patients were not fit for surgery for comorbidities or refused surgery. Among these 3 patients had symptomatic insulinomas with severe difficulties to control glycemic imbalance.

Results:

10 patients had 11 pNETs with a 14.5 mm size (9 – 24 mm) respectively located in 3 cases to the head, 6 to the body, 2 to the tail. The mean duration of hospital stay was 4 days. There were not early or late complications. All the patients at at least 12 months of follow up had complete disappearance of the lesions with not symptoms recurrence.

Conclusions:

Our series confirm the feasibility of EUS-RFA for the treatment of functions or non functions pNets by using a novel EUS-RFA needle electrode. Excellent beneficial effects were immediate and maintained for months with no adverse events.