Endoscopic Ultrasound-guided Radiofrequency Ablation Versus Surgical Resection for Treatment of Pancreatic Insulinoma
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Endoscopic Ultrasound-guided Radiofrequency Ablation Versus Surgical Resection for Treatment of Pancreatic Insulinoma. / Crinò, Stefano Francesco; Napoleon, Bertrand; Facciorusso, Antonio; Lakhtakia, Sundeep; Borbath, Ivan; Caillol, Fabrice; Do-Cong Pham, Khanh; Rizzatti, Gianenrico; Forti, Edoardo; Palazzo, Laurent; Belle, Arthur; Vilmann, Peter; van Laethem, Jean Luc; Mohamadnejad, Mehdi; Godat, Sebastien; Hindryckx, Pieter; Benson, Ariel; Tacelli, Matteo; De Nucci, Germana; Binda, Cecilia; Kovacevic, Bojan; Jacob, Harold; Partelli, Stefano; Falconi, Massimo; Salvia, Roberto; Landoni, Luca; Larghi, Alberto; the ERASING study collaborators.
I: Clinical Gastroenterology and Hepatology, Bind 21, Nr. 11, 2023, s. 2834-2843.e2.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Endoscopic Ultrasound-guided Radiofrequency Ablation Versus Surgical Resection for Treatment of Pancreatic Insulinoma
AU - Crinò, Stefano Francesco
AU - Napoleon, Bertrand
AU - Facciorusso, Antonio
AU - Lakhtakia, Sundeep
AU - Borbath, Ivan
AU - Caillol, Fabrice
AU - Do-Cong Pham, Khanh
AU - Rizzatti, Gianenrico
AU - Forti, Edoardo
AU - Palazzo, Laurent
AU - Belle, Arthur
AU - Vilmann, Peter
AU - van Laethem, Jean Luc
AU - Mohamadnejad, Mehdi
AU - Godat, Sebastien
AU - Hindryckx, Pieter
AU - Benson, Ariel
AU - Tacelli, Matteo
AU - De Nucci, Germana
AU - Binda, Cecilia
AU - Kovacevic, Bojan
AU - Jacob, Harold
AU - Partelli, Stefano
AU - Falconi, Massimo
AU - Salvia, Roberto
AU - Landoni, Luca
AU - Larghi, Alberto
AU - the ERASING study collaborators
N1 - Publisher Copyright: © 2023 AGA Institute
PY - 2023
Y1 - 2023
N2 - Background & Aims: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is emerging as a safe and effective treatment for pancreatic neuroendocrine tumors. We aimed to compare EUS-RFA and surgical resection for the treatment of pancreatic insulinoma (PI). Methods: Patients with sporadic PI who underwent EUS-RFA at 23 centers or surgical resection at 8 high-volume pancreatic surgery institutions between 2014 and 2022 were retrospectively identified and outcomes compared using a propensity-matching analysis. Primary outcome was safety. Secondary outcomes were clinical efficacy, hospital stay, and recurrence rate after EUS-RFA. Results: Using propensity score matching, 89 patients were allocated in each group (1:1), and were evenly distributed in terms of age, sex, Charlson comorbidity index, American Society of Anesthesiologists score, body mass index, distance between lesion and main pancreatic duct, lesion site, size, and grade. Adverse event (AE) rate was 18.0% and 61.8% after EUS-RFA and surgery, respectively (P < .001). No severe AEs were observed in the EUS-RFA group compared with 15.7% after surgery (P < .0001). Clinical efficacy was 100% after surgery and 95.5% after EUS-RFA (P = .160). However, the mean duration of follow-up time was shorter in the EUS-RFA group (median, 23 months; interquartile range, 14-31 months vs 37 months; interquartile range, 17.5-67 months in the surgical group; P < .0001). Hospital stay was significantly longer in the surgical group (11.1 ± 9.7 vs 3.0 ± 2.5 days in the EUS-RFA group; P < .0001). Fifteen lesions (16.9%) recurred after EUS-RFA and underwent a successful repeat EUS-RFA (11 patients) or surgical resection (4 patients). Conclusion: EUS-RFA is safer than surgery and highly effective for the treatment of PI. If confirmed in a randomized study, EUS-RFA treatment can become first-line therapy for sporadic PI.
AB - Background & Aims: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is emerging as a safe and effective treatment for pancreatic neuroendocrine tumors. We aimed to compare EUS-RFA and surgical resection for the treatment of pancreatic insulinoma (PI). Methods: Patients with sporadic PI who underwent EUS-RFA at 23 centers or surgical resection at 8 high-volume pancreatic surgery institutions between 2014 and 2022 were retrospectively identified and outcomes compared using a propensity-matching analysis. Primary outcome was safety. Secondary outcomes were clinical efficacy, hospital stay, and recurrence rate after EUS-RFA. Results: Using propensity score matching, 89 patients were allocated in each group (1:1), and were evenly distributed in terms of age, sex, Charlson comorbidity index, American Society of Anesthesiologists score, body mass index, distance between lesion and main pancreatic duct, lesion site, size, and grade. Adverse event (AE) rate was 18.0% and 61.8% after EUS-RFA and surgery, respectively (P < .001). No severe AEs were observed in the EUS-RFA group compared with 15.7% after surgery (P < .0001). Clinical efficacy was 100% after surgery and 95.5% after EUS-RFA (P = .160). However, the mean duration of follow-up time was shorter in the EUS-RFA group (median, 23 months; interquartile range, 14-31 months vs 37 months; interquartile range, 17.5-67 months in the surgical group; P < .0001). Hospital stay was significantly longer in the surgical group (11.1 ± 9.7 vs 3.0 ± 2.5 days in the EUS-RFA group; P < .0001). Fifteen lesions (16.9%) recurred after EUS-RFA and underwent a successful repeat EUS-RFA (11 patients) or surgical resection (4 patients). Conclusion: EUS-RFA is safer than surgery and highly effective for the treatment of PI. If confirmed in a randomized study, EUS-RFA treatment can become first-line therapy for sporadic PI.
KW - Acute pancreatitis
KW - Hypoglycemia
KW - Insulin
KW - Neuroendocrine Tumor
KW - Pancreatic Fistula
U2 - 10.1016/j.cgh.2023.02.022
DO - 10.1016/j.cgh.2023.02.022
M3 - Journal article
C2 - 36871765
AN - SCOPUS:85151518633
VL - 21
SP - 2834-2843.e2
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
SN - 1542-3565
IS - 11
ER -
ID: 363064996