Endoscopic ultrasound guided radiofrequency ablation for pancreatic tumors: A critical review focusing on safety, efficacy and controversies

Table 1 Studies reporting endoscopic ultrasound-radiofrequency ablation for pancreatic neuroendocrine neoplasms

Ref.	Type of study (pNEN type)	Patients/lesions/RFA sessions, n	Location, n	Mean size (range) in mm	Histological grade (KI67%)	Technical success, n (%)	Adverse events, n (%)	Complete radiological/ clinical1 resolution, n (%)	Mean follow-up in mo
Rossi et al[10]	Case report (nonfunctional)	1/1/1	Head (1)	10	NR	1 (100)	0	1 (100)	34
Armellini et al[11]	Case report (nonfunctional)	1/1/1	Tail (1)	20	G2 (> 5)	1 (100)	0	1 (100)	1
Lakhtakia et al[12]	Case series (insulinoma)	3/3/3	Body (2), diffuse (1)	17.7 (14-22)	NR	3 (100)	0	3 (100)/3 (100)	4.2
Waung et al[21]	Case report (insulinoma)	1/1/3	Uncinate (1)	18	NR	1 (100)	0	1 (100)/1 (100)	10
Bas-Cutrina et al[22]	Case report (insulinoma)	1/1/1	Body (1)	10	NR	1 (100)	0	1 (100)/1 (100)	10
Pai et al[23]	Prospective (nonfunctional)	2/2/3	Head (1)	27.5 (15-40)	NR	2 (100)	0	2 (100)	6
Barthet et al[13]	Prospective (nonfunctional)	12/14/12	Head (3), body (6), tail (5)	13.1 (10-20)	G1	12 (100)	2 (16.7)2	9 (75)	12
Choi et al[25]	Prospective (nonfunctional-7), (insulinoma-1)	8/8/14	Head (3), body (5)	19.25 (8-28)	Reported in 2 patients (G1 and G2)	8 (100)	2 (14.3)3	6 (75)/1 (100)	13
de Nucci et al[26]	Prospective (nonfunctional)	10/11/10	Head (3), body (8), tail (2)	14.5 (9-20)	G1 (< 4)	10 (100)	2 (20)4	10 (100)	12
Oleinikov et al[14]	Retrospective (nonfunctional-11), (insulinoma-7)	18/27/18	Head (10), body (8), tail (2), uncinate (5), metastasis (2)	14.8 (12-19)	G1 (< 5) in 15 patents, G3 (34-40) in 2 patients	18 (100)	2 (11.1)5	17 (94.4)/7 (100)	8.7
Rossi et al[30]	Case series (insulinoma)	3/3/4	NR	11.5 (9-14)	NR	3 (100)	1 (25)6	3 (100)/3 (100)	8.5
Chang et al[27]	Case report (insulinoma)	1/1/1	Head (1)	12	NR	1 (100)	0	1 (100)/1 (100)	18
Kluz et al[28]	Case report (insulinoma)	1/1/1	Head (1)	9	NR	1 (100)	1 (100)7	NR/1 (100)	NR
Furnica et al[29]	Case series (insulinoma)	4/4/4	Head (2), neck (1), tail (1)	12.9 (6.5-22.0)	G1 in 3 patients and G2 in 1 patient	4 (100)	2 (50)8	4 (100)/4 (100)	22
Marx et al[15]	Retrospective (insulinoma)	7/7/7	Head (1), body (1), neck (3), body-tail junction (2)	13.3 (8-20)	G1 (< 3) in 4 patient, G2 (4) in 1 patient	7 (100)	4 (57.1)9	6 (85.7)/7 (100)	20.3
Marx et al[31]	Retrospective (non-functional)	27/27/31	Head (6), body (3), tail (11), uncinate (2), body-tail junction (5)	14 (7-25)	G1 (< 3) in 25 patients, NR in 2 patients	27 (100)	9 (29)10	25 (92.6)	15.7
Pooled data	Case reports: 9. Prospective: 4. Retrospective: 3	100/112/114	Head and neck (33), body (34), tail (22), uncinate (8), metastasis and diffuse (3), junction (7)	14.8	Unable to pool due to data lacking	96 (100)	25 (21.9)	90 (90)/21 (100)	13

¹Insulinoma.

²Infected pancreatic necrosis (1 patient, moderate), pancreatic duct stenosis (1 patient, moderate).

³Pancreatitis (1 patient, moderate), transient abdominal pain (1 patient, mild).

⁴Transient abdominal pain (2 patients, mild).

⁵Pancreatitis (2 patients, mild).

⁶Intraprocedural bleeding treated endoscopically (1 patient, moderate).

⁷Acute necrotizing pancreatitis (1 patient, moderate).

⁸Pancreatitis (2 patients, mild).

⁹Transient abdominal pain (1 patient, mild), pancreatitis (1 patient, moderate), coagulation necrosis (1 patient, moderate), retrogastric collection (1 patient, refused drainage, died 2 wk later, severe).

¹⁰Transient abdominal pain (3 patients, mild), pancreatitis (1 patient, moderate), periprocedural bleeding (2 patients, moderate), pancreatitis complicated by retrogastric or perisplenic collection managed by endoscopic drainage and antibiotic treatment (2 patients, moderate), pancreatitis with pancreatic fistula and paragastric collection drained by endoscopic cystgastrostomy (1 patient, moderate).

pNEN: Pancreatic neuroendocrine neoplasms; NR: Not reported; RFA: Radiofrequency ablation.