EUS-guided radiofrequency ablation for pancreatic insulinoma: experience in 2 tertiary centers

• Published in: Gastrointestinal endoscopy Vol. 95; no. 6; pp. 1256 - 1263
• Main Authors: Marx, Mariola, Trosic-Ivanisevic, Toni, Caillol, Fabrice, Demartines, Nicolas, Schoepfer, Alain, Pesenti, Christian, Ratone, Jean-Philippe, Robert, Maxime, Giovannini, Marc, Godat, Sébastien
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2022
• Subjects: NET; EUS-RFA
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2021.11.045

Insulinoma is the most frequent functional neuroendocrine tumor of the pancreas, and preserving surgery is the treatment of choice. EUS-guided radiofrequency ablation (EUS-RFA) is a novel and promising technique that induces tissue necrosis of localized lesions. This article presents a preliminary clinical experience in treating pancreatic insulinomas <2 cm by EUS-RFA, focusing on safety and efficacy. The clinical course of patients with pancreatic insulinoma treated by EUS-RFA at 2 tertiary referral centers was analyzed. Between November 2017 and December 2020, 7 patients were included (6 women; mean age, 66 years). EUS-RFA was feasible in all patients with immediate hypoglycemia relief after only 1 single treatment session; 6 of 7 achieved complete response by cross-sectional imaging and remained asymptomatic (median follow-up, 21 months; range, 3-38). Three patients had minor adverse events. One elderly patient developed a large retrogastric collection 15 days after treatment and died 1 month after EUS-RFA. Management of pancreatic neuroendocrine tumors <2 cm by EUS-RFA seems to be effective with an acceptable safety profile. However, further evidence focusing on long-term survival and recurrence is needed.