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Review
. 2022 May-Jun;11(3):170-185.
doi: 10.4103/EUS-D-21-00044.

EUS-guided radiofrequency and ethanol ablation for pancreatic neuroendocrine tumors: A systematic review and meta-analysis

Rajat Garg  1 , Abdul Mohammed  1 , Amandeep Singh  1 , Mary P Harnegie  2 , Tarun Rustagi  3 , Tyler Stevens  1 , Prabhleen Chahal  1
Affiliations
Review

EUS-guided radiofrequency and ethanol ablation for pancreatic neuroendocrine tumors: A systematic review and meta-analysis

Rajat Garg et al. Endosc Ultrasound. 2022 May-Jun.

Abstract

EUS-guided radiofrequency ablation (RFA) and ethanol ablation (EA) for pancreatic neuroendocrine tumors (PNETs) have recently been reported with good outcomes. We performed a systematic review and meta-analysis to evaluate the comparative effectiveness and safety of EUS-RFA and EUS-EA in the treatment of PNETs. A comprehensive search of multiple databases (through October 2020) was performed to identify studies that reported outcomes of EUS-RFA and EUS-EA of PNETs. Outcomes assessed included clinical success, technical success, and adverse events (AEs). A total of 181 (100 EUS-RFA, 81 EUS-EA) patients (60.7 ± 9.2 years) with 204 (113 EUS-RFA, 91 EUS-EA) PNETs (mean size 15.1 ± 4.7 mm) were included from 20 studies. There was no significant difference in the rates of technical success (94.4% [95% confidence interval (CI): 88.5-97.3, I2 = 0] vs. 96.7% [95% CI: 90.8-98.8, I2 = 0]; P = 0.42), clinical success (85.2% (95% CI: 75.9-91.4, I2 = 0) vs. 82.2% [95% CI: 68.2-90.8, I2 = 10.1]; P = 0.65), and AEs (14.1% [95% CI: 7.1-26.3, I2 = 0] vs. 11.5% [95% CI: 4.7-25.4, I2 = 63.5]; P = 0.7) between EUS-RFA and EUS-EA, respectively. The most common AE was pancreatitis with the rate of 7.8% and 7.6% (P = 0.95) for EUS-RFA and EUS-EA, respectively. On meta-regression, the location of PNETs in head/neck of pancreas (P = 0.03) was a positive predictor of clinical success for EUS-RFA. EUS-RFA and EUS-EA have similar effectiveness and safety for PNETs ablation. Head/neck location of PNETs was a positive predictor for clinical success after EUS-RFA.

Keywords: EUS; ethanol; neuroendocrine tumor; pancreas; radiofrequency ablation.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Forest plot showing pooled rates of clinical success (a) and technical success (b) after EUS–radiofrequency ablation and EUS-EA of pancreatic neuroendocrine tumors
Figure 2
Figure 2
Forest plot showing pooled rates of adverse events (a) and pancreatitis (b) after EUS–radiofrequency ablation and EUS-EA of pancreatic neuroendocrine tumors
Figure 3
Figure 3
Scatter plot showing the relationship of head/neck location and clinical success after EUS-radiofrequency ablation of pancreatic neuroendocrine tumors
Figure 4
Figure 4
Funnel plot assessing publication bias with filled studies
See this image and copyright information in PMC

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References

    1. Klöppel G, Anlauf M, Perren A. Endocrine precursor lesions of gastroenteropancreatic neuroendocrine tumors. Endocr Pathol. 2007;18:150–5. - PubMed
    1. Mallinson CN, Bloom SR, Warin AP, et al. A glucagonoma syndrome. Lancet. 1974;2:1–5. - PubMed
    1. Metz DC, Jensen RT. Gastrointestinal neuroendocrine tumors: Pancreatic endocrine tumors. Gastroenterology. 2008;135:1469–92. - PMC - PubMed
    1. Oberg K, Eriksson B. Endocrine tumours of the pancreas. Best Pract Res Clin Gastroenterol. 2005;19:753–81. - PubMed
    1. Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid”: Epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26:3063–72. - PubMed