Safety and efficacy of endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine neoplasms: Systematic review and meta-analysis

Tawfik Khoury, Wisam Sbeit, Pietro Fusaroli, Davide Campana, Nicole Brighi, Bertrand Napoleon, Andrea Lisotti

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Objective: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been constantly increasing, particularly in the treatment of pancreatic neuroendocrine neoplasms (pNENs). While emerging data in this field are accumulating, we aimed to assess the pooled efficacy and safety of EUS-RFA for pNENs. Methods: The PubMed/Medline, Embase, and Cochrane Library databases search was conducted to identify studies reporting EUS-RFA of pNENs with outcomes of interest (efficacy and safety). The primary outcome was radiological response. Efficacy was assessed by the pooled clinical response rate, whereas safety was assessed by the pooled adverse events (AEs) rate. Heterogeneity was assessed using I2. Pooled estimates and the 95% confidence interval (CI) were calculated using a random-effect model. Results: Eleven studies involving 292 patients were included. The pooled technical success rate was 99.2% (95% CI 97.9–99.9%), with no heterogeneity. The pooled complete radiological response was 87.1% (95% CI 80.1–92.8%). The pooled partial response was 11.4% (95% CI 6.2–18.1%). The pooled clinical response rate for functional pNENs was 94.9% (95% CI 90.7–97.9%), with no heterogeneity. The pooled incidence of AEs was 20.0% (95% CI 14.0–26.7%); most AEs were mild to moderate in grade, while the pooled incidence of severe AEs was 0.9% (95% CI 0.2–2.3%). The most common AEs were transient mild abdominal pain in 19 patients (6.5%), and mild to moderate pancreatitis in 23 patients (7.9%). No cases of mortality were reported. Conclusion: Endoscopic ultrasound-guided radiofrequency ablation resulted on a feasible approach for pNENs treatment, with excellent technical success, high radiological and clinical response, and acceptable AE rate.

Original languageEnglish
Pages (from-to)395-405
Number of pages11
JournalDigestive Endoscopy
Volume36
Issue number4
Early online date13 Sep 2023
DOIs
StatePublished - Apr 2024

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.

Keywords

  • efficacy
  • meta-analysis
  • neuroendocrine tumor
  • pancreas
  • safety

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