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Systematic Review and Meta-analysis
- Cryotherapy versus radiofrequency ablation in the treatment of dysplastic Barrett’s esophagus with or without early esophageal neoplasia: a systematic review and meta-analysis
- Igor Logetto Caetité Gomes, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Sérgio Barbosa Marques, Alexandre de Sousa Carlos, Beanie Conceição Medeiros Nunes, Bruno Salomão Hirsch, Guilherme Henrique Peixoto de Oliveira, Roberto Paolo Trasolini, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
- Clin Endosc 2024;57(2):181-190. Published online January 17, 2024
- DOI: https://doi.org/10.5946/ce.2023.065
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Graphical Abstract
Abstract
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Supplementary Material
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ePub - Background
/Aims: Radiofrequency ablation (RFA) is the first-line therapy for dysplastic Barrett’s esophagus (BE). Therefore, cryotherapy has emerged as an alternative treatment option. This study aimed to compare the efficacies of these two techniques based on the rates of complete eradication of intestinal metaplasia (CE-IM) and dysplasia (CE-D). Adverse events and recurrence have also been reported.
Methods
An electronic search was conducted using the Medline (PubMed), Embase, LILACS, and Google Scholar databases until December 2022. Studies were included comparing cryotherapy and RFA for treating dysplastic BE with or without early esophageal neoplasia. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results
Three retrospective cohort studies involving 627 patients were included. Of these, 399 patients underwent RFA, and 228 were treated with cryotherapy. There was no difference in CE-IM (risk difference [RD], –0.03; 95% confidence interval [CI], –0.25 to 0.19; p=0.78; I2=86%) as well as in CE-D (RD, –0.03; 95% CI, –0.15 to 0.09; p=0.64; I2=70%) between the groups. The absolute number of adverse events was low, and there was no difference in the recurrence rate.
Conclusions
Cryotherapy and RFA were equally effective in treating dysplastic BE, with or without early esophageal neoplasia.
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- 205 Download
Review
- Role of radiofrequency ablation in advanced malignant hilar biliary obstruction
- Mamoru Takenaka, Tae Hoon Lee
- Clin Endosc 2023;56(2):155-163. Published online January 16, 2023
- DOI: https://doi.org/10.5946/ce.2022.218
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Abstract
PDFPubReaderePub
- Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.
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Citations
Citations to this article as recorded by
- Percutaneous endobiliary radiofrequency ablation with stent placement in type IV hilar cholangiocarcinoma: A prospective comparison with stent placement alone
Kun Yung Kim, Chang Jin Yoon, Jae Hwan Lee, Chong-Ho Lee, Jin-Hyeok Hwang, Jaihwan Kim
European Journal of Radiology.2024; 176: 111516. CrossRef - Metastatic Cholangiocarcinoma Presenting as Colonic Obstruction
Yianni Protopapadakis, Kevin Lamm, Joseph Baber
ACG Case Reports Journal.2023; 10(12): e01238. CrossRef - Is endoscopic radiofrequency ablation plus stent placement superior to stent placement alone for the treatment of malignant biliary obstruction? A systematic review and meta-analysis
Chenming Liu, Jiaming Dong, Yuxing Liu, Siyuan Zhang, Ruanchang Chen, Haijun Tang
Journal of International Medical Research.2023;[Epub] CrossRef
- Percutaneous endobiliary radiofrequency ablation with stent placement in type IV hilar cholangiocarcinoma: A prospective comparison with stent placement alone
- 2,879 View
- 246 Download
- 2 Web of Science
- 3 Crossref
Original Article
- Survival Benefit of Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction: A Systematic Review with Meta-Analysis
- Byung Hyo Cha, Myoung-Jin Jang, Sang Hyub Lee
- Clin Endosc 2021;54(1):100-106. Published online January 15, 2021
- DOI: https://doi.org/10.5946/ce.2020.254
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Abstract
PDFPubReaderePub
- Background
/Aims: Cholangiocarcinoma (CCA) is a rare but aggressive disease with a poor survival. Recent trials have shown improved survival with intraductal radiofrequency ablation (RFA) therapy. We performed a systematic review with meta-analysis to determine the survival benefit of endoscopic RFA for unresectable extrahepatic CCA with malignant biliary obstruction (MBO).
Methods
A systematic search from 1970 to 2020 was performed in MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials. gov. We selected eligible studies reporting relative risks, hazard ratios (HRs), or odds ratios, adjusted by controlling for confounding factors of survival rate and stent patency duration, among patients with extrahepatic CCA with MBO treated with RFA with stent insertion or stent insertion only.
Results
A total of eight trials (three randomized and five nonrandomized) with a total of 420 patients were included in the metaanalysis. Pooled overall survival analysis favored RFA treatment with stent insertion (HR, 0.47; 95% confidence interval [CI], 0.34– 0.64; I2=47%; p=0.09); however, no significant difference was found in the duration of stent patency between the groups (HR, 0.79; 95% CI, 0.57–1.09; I2=7%; p=0.36).
Conclusions
RFA therapy with stent insertion may confer a survival benefit compared with stent insertion only in patients with CCA and MBO. -
Citations
Citations to this article as recorded by- Intraductal radiofrequency ablation plus biliary stent versus stent alone for malignant biliary obstruction: a systematic review and meta-analysis
Matheus de Oliveira Veras, Diogo Turiani Hourneaux de Moura, Thomas R. McCarty, Guilherme Henrique Peixoto de Oliveira, Rômulo Sérgio Araújo Gomes, Davi Lucena Landim, Felipe Giacobo Nunes, Tomazo Antônio Prince Franzini, Marcos Eduardo Lera dos Santos, W
Endoscopy International Open.2024; 12(01): E23. CrossRef - Reply to Chandrasekhara and Aggarwal
Matheus de Oliveira Veras, Diogo Turiani Hourneaux de Moura, Eduardo Guimarães Hourneaux de Moura
Endoscopy International Open.2024; 12(05): E640. CrossRef - Consensus statements on endoscopic radiofrequency ablation for malignant biliary strictures
Journal of Digestive Diseases.2024; 25(1): 2. CrossRef - The Impact of Radiofrequency Ablation on Survival Outcomes and Stent Patency in Patients with Unresectable Cholangiocarcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Daniele Balducci, Michele Montori, Francesco Martini, Marco Valvano, Federico De Blasio, Maria Eva Argenziano, Giuseppe Tarantino, Antonio Benedetti, Emanuele Bendia, Marco Marzioni, Luca Maroni
Cancers.2024; 16(7): 1372. CrossRef - Impact of temperature-controlled endobiliary radiofrequency ablation for inoperable hilar cholangiocarcinoma: A propensity score–matched analysis
Il Sang Shin, Jong Ho Moon, Yun Nah Lee, Jun Ho Myeong, Tae Hoon Lee, Jae Kook Yang, Young Deok Cho, Sang-Heum Park
Endoscopy International Open.2024; 12(04): E535. CrossRef - Feasibility and safety of trans-biliary cryoablation: Preclinical evaluation of a novel flexible cryoprobe
Chao Zhang, Linzhong Zhu, Shousheng Tang, Jukun Wang, Yu Li, Xin Chen, Chunjing Bian, Dongbin Liu, Guokun Ao, Tao Luo
Cryobiology.2023; 111: 40. CrossRef - Efficacy and Safety of Radiofrequency Ablation Plus Stent Versus Stent-alone Treatments for Malignant Biliary Strictures
Hayat Khizar, Yufei Hu, Yanhua Wu, Kamran Ali, Junaid Iqbal, Muhammad Zulqarnain, Jianfeng Yang
Journal of Clinical Gastroenterology.2023; 57(4): 335. CrossRef - Development of novel biliary metal stent with coil-spring structure and its application in vivo swine biliary stricture model
In Rae Cho, Sang Hyub Lee, Jin Ho Choi, Namyoung Park, Min Woo Lee, Joo Seong Kim, Seok Jeong, Don Haeng Lee, Tae-Won Jeong, Byoung-Yun Ki, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
Frontiers in Oncology.2023;[Epub] CrossRef - In-stent radiofrequency ablation with uncovered metal stent placement for tumor ingrowth/overgrowth causing self-expandable metal stent occlusion in distal malignant biliary obstruction: multicenter propensity score–matched study
Namyoung Park, Min Kyu Jung, Eui Joo Kim, Woo Hyun Paik, Jae Hee Cho
Gastrointestinal Endoscopy.2023; 97(4): 694. CrossRef - ACG Clinical Guideline: Diagnosis and Management of Biliary Strictures
B. Joseph Elmunzer, Jennifer L. Maranki, Victoria Gómez, Anna Tavakkoli, Bryan G. Sauer, Berkeley N. Limketkai, Emily A. Brennan, Elaine M. Attridge, Tara J. Brigham, Andrew Y. Wang
American Journal of Gastroenterology.2023; 118(3): 405. CrossRef - Effect of radiofrequency ablation in addition to biliary stent on overall survival and stent patency in malignant biliary obstruction: an updated systematic review and meta-analysis
Zahid Ijaz Tarar, Umer Farooq, Mustafa Gandhi, Ghulam Ghous, Saad Saleem, Faisal Kamal, Zaid Imam, Laith Jamil
European Journal of Gastroenterology & Hepatology.2023; 35(6): 646. CrossRef - Impact of endobiliary radiofrequency ablation on survival of patients with unresectable cholangiocarcinoma: a narrative review
Elena Di Girolamo, Andrea Belli, Alessandro Ottaiano, Vincenza Granata, Valentina Borzillo, Luca Tarotto, Fabiana Tatangelo, Raffaele Palaia, Corrado Civiletti, Mauro Piccirillo, Valentina D’Angelo, Francesco Fiore, Pietro Marone, Guglielmo Nasti, Frances
Frontiers in Oncology.2023;[Epub] CrossRef - Endoluminal radiofrequency ablation in patients with malignant biliary obstruction: a randomised trial
Jana Jarosova, Lea Zarivnijova, Ivana Cibulkova, Jan Mares, Peter Macinga, Alzbeta Hujova, Premysl Falt, Ondrej Urban, Jan Hajer, Julius Spicak, Tomas Hucl
Gut.2023; 72(12): 2286. CrossRef - Is endoscopic radiofrequency ablation plus stent placement superior to stent placement alone for the treatment of malignant biliary obstruction? A systematic review and meta-analysis
Chenming Liu, Jiaming Dong, Yuxing Liu, Siyuan Zhang, Ruanchang Chen, Haijun Tang
Journal of International Medical Research.2023;[Epub] CrossRef - Intraductal Therapies for Cholangiocarcinoma
Abhishek Agnihotri, David E. Loren
Techniques and Innovations in Gastrointestinal Endoscopy.2022; 24(2): 200. CrossRef - Silver Nanofunctionalized Stent after Radiofrequency Ablation Suppresses Tissue Hyperplasia and Bacterial Growth
Yubeen Park, Dong-Sung Won, Ga-Hyun Bae, Dae Sung Ryu, Jeon Min Kang, Ji Won Kim, Song Hee Kim, Chu Hui Zeng, Wooram Park, Sang Soo Lee, Jung-Hoon Park
Pharmaceutics.2022; 14(2): 412. CrossRef - Comparison of Intraductal RFA Plus Stent versus Stent-Only Treatment for Unresectable Perihilar Cholangiocarcinoma—A Systematic Review and Meta-Analysis
David M. de Jong, Jeska A. Fritzsche, Amber S. Audhoe, Suzanne S. L. Yi, Marco J. Bruno, Rogier P. Voermans, Lydi M. J. W. van Driel
Cancers.2022; 14(9): 2079. CrossRef - Evaluation and Management of Malignant Biliary Obstruction
Nadia V. Guardado, Kaysey Llorente, Benoit Blondeau
Surgical Oncology Clinics of North America.2021; 30(3): 491. CrossRef
- Intraductal radiofrequency ablation plus biliary stent versus stent alone for malignant biliary obstruction: a systematic review and meta-analysis
- 4,131 View
- 152 Download
- 17 Web of Science
- 18 Crossref
Focused Review Series: Cutting Edge of Advanced Therapeutic Endoscopy
- Management of Remnant or Recurrent Lesions after Endoscopic Papillectomy
- Ichiro Yasuda, Saito Kobayashi, Kosuke Takahashi, Sohachi Nanjo, Hiroshi Mihara, Shinya Kajiura, Takayuki Ando, Kazuto Tajiri, Haruka Fujinami
- Clin Endosc 2020;53(6):659-662. Published online December 3, 2019
- DOI: https://doi.org/10.5946/ce.2019.171
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Abstract
PDFPubReaderePub
- Endoscopic papillectomy (EP) for ampullary adenomas achieves cure rates ranging from 76% to 90%, and recurrence rates are as high as 33%. If remnant or recurrent lesions after prior EP are endoscopically visible and are not suspected of intraductal extension into the biliary or pancreatic duct, repeated snaring and cutting can be performed until all visible lesions are completely resected. However, endoscopic ablative therapies, particularly argon plasma coagulation, can be attempted for tiny or uncertain remnant and recurrent lesions. In addition, intraductal radiofrequency ablation has recently been attempted for residual intraductal lesions after EP at several institutions. Although still under investigation, it has shown some promise. It might be offered as an alternative to surgery, particularly in patients who are unfit for surgery or those who refuse to undergo surgery.
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Citations
Citations to this article as recorded by- The timing of recurrence after endoscopic papillectomy
Samuel Han, Joshua A. Turkeltaub, Daniel Jonas, Augustin R. Attwell, Anna M. Duloy, Steven A. Edmundowicz, Hazem T. Hammad, Mihir S. Wagh, Sachin Wani, Raj J. Shah
Surgical Endoscopy.2024; 38(2): 688. CrossRef - Outcomes of rescue procedures in the management of locally recurrent ampullary tumors: A Pancreas 2000/EPC study
Elias Karam, Marcus Hollenbach, Einas Abou Ali, Francesco Auriemma, Aiste Gulla, Christian Heise, Sara Regner, Sébastien Gaujoux, Jean M. Regimbeau, Georg Kähler, Steffen Seyfried, Jean C. Vaillant, Charles De Ponthaud, Alain Sauvanet, David Birnbaum, Nic
Surgery.2023; 173(5): 1254. CrossRef - The first Russian experience of radiofrequency ablation in the treatment of adenoma of the major duodenal papilla with intraductal growth in the common bile duct
L.R. Tigiyev, Yu.S. Teterin, P.A. Yartsev, S.S. Petrikov
Khirurgiya. Zhurnal im. N.I. Pirogova.2023; (8): 70. CrossRef - The Significance of Histopathological Findings on Clinical Outcomes in Endoscopic Papillectomy with Endocut
Sayaka Miyamoto, Masahiro Serikawa, Yasutaka Ishii, Yumiko Tatsukawa, Shinya Nakamura, Juri Ikemoto, Yosuke Tamura, Kazuki Nakamura, Masaru Furukawa, Yumiko Yamashita, Noriaki Iijima, Koji Arihiro, Shiro Oka
Journal of Clinical Medicine.2023; 12(21): 6853. CrossRef - Clinical outcomes of endoscopic papillectomy of ampullary adenoma: A multi-center study
Seong Ji Choi, Hong Sik Lee, Jiyeong Kim, Jung Wan Choe, Jae Min Lee, Jong Jin Hyun, Jai Hoon Yoon, Hyo Jung Kim, Jae Seon Kim, Ho Soon Choi
World Journal of Gastroenterology.2022; 28(17): 1845. CrossRef - Endoscopic papillectomy for ampullary adenoma and early adenocarcinoma: Analysis of factors related to treatment outcome and long‐term prognosis
Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Tadashi Iida, Hiroyuki Tanaka, Kazuhiro Furukawa, Masanao Nakamura, Takashi Honda, Senju Hashimoto, Akihiro Itoh, Masatoshi Ishigami, Yoshiki Hirooka, Mitsuhiro Fujishiro
Digestive Endoscopy.2021; 33(5): 858. CrossRef - Predictive factor of recurrence after endoscopic papillectomy for ampullary neoplasms
Kosuke Takahashi, Eisuke Ozawa, Ichiro Yasuda, Naohiro Komatsu, Hisamitsu Miyaaki, Ken Ohnita, Takuji Yamao, Kazuo Oba, Tatsuki Ichikawa, Kazuhiko Nakao
Journal of Hepato-Biliary-Pancreatic Sciences.2021; 28(7): 625. CrossRef - Management of obstructive jaundice in patients with neoplasms of the major duodenal papilla
Yu.S. Teterin, L.R. Tigiev, P.A. Yartsev, E.V. Stepan, M.L. Rogal, Yu.D. Kulikov
Khirurgiya. Zhurnal im. N.I. Pirogova.2021; (7): 49. CrossRef - Underwater endoscopic papillectomy for residual tumor after endoscopic papillectomy: First report
Yuki Mori, Akira Kurita, Shujiro Yazumi
Digestive Endoscopy.2020;[Epub] CrossRef - Diagnosis and treatment of benign neoplasms of the major duodenal papilla
Yu.S. Teterin, P.A. Yartsev, M.L. Rogal, L.R. Tigiev, N.V. Shavrina, K.A. Nugumanova, E.V. Stepan
Khirurgiya. Zhurnal im. N.I. Pirogova.2020; (11): 32. CrossRef
- The timing of recurrence after endoscopic papillectomy
- 5,488 View
- 215 Download
- 7 Web of Science
- 10 Crossref
Focused Review Series: Expanding Indication: Interventional Endoscopic Management for Pancreaticobiliary Diseases
- Endoscopic Palliation for Biliary and Pancreatic Malignancies: Recent Advances
- Zaheer Nabi, D. Nageshwar Reddy
- Clin Endosc 2019;52(3):226-234. Published online January 22, 2019
- DOI: https://doi.org/10.5946/ce.2019.003
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Abstract
PDFPubReaderePub
- Malignancies of the pancreatobiliary system are usually unresectable at the time of diagnosis. As a consequence, a majority of these cases are candidates for palliative care. With advances in chemotherapeutic agents and multidisciplinary care, the survival rate in pancreatobiliary malignancies has improved. Therefore, there is a need to provide an effective and long-lasting palliative care for these patients. Endoscopic palliation is preferred to surgery as the former is associated with equal efficacy and reduced morbidity. The main role of endoscopic palliation in the vast majority of pancreatobiliary malignancies includes biliary and enteral stenting for malignant obstructive jaundice and gastric outlet obstruction, respectively. Recent advances in endoscopic palliation appear promising in imparting long-lasting relief of symptoms. Use of radiofrequency ablation and photodynamic therapy in malignant biliary obstruction has been shown to improve the survival rates as well as the patency of biliary stents. The emergence of endoscopic ultrasound (EUS) as a therapeutic tool has enhanced the capability of minimally invasive palliation in pancreatobiliary cancers. EUS is a valuable alternative to endoscopic retrograde cholangiopancreatography for the palliation of obstructive jaundice. More recently, EUS is emerging as an effective primary modality for biliary and gastric bypass.
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Citations
Citations to this article as recorded by- International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Clinical Endoscopy.2024; 57(2): 141. CrossRef - Palliative Interventions and Best Supportive Care in Biliary Malignancy
Christine Chung, Lauren Wancata
Surgical Clinics of North America.2024;[Epub] CrossRef - Gamma-Glutamyl Transferase: A Friend against Cholestatic Itch? A Retrospective Observational Data Analysis in Patients with Extrahepatic Cholestasis
Floris W. Haijer, Cornelis B. Van Vliet, Marjolein G. J. Brusse-Keizer, Job A. M. Van der Palen, Marjo J. Kerbert-Dreteler, Jeroen J. Kolkman, Dirk Uhlmann
International Journal of Hepatology.2023; 2023: 1. CrossRef - Endoscopic and Endosonographic Palliation for Triple Obstruction Caused by Recurrent Gallbladder Cancer: A Case Report
Young Rong Kim, Chi Hyuk Oh, Min Jae Yang
The Korean Journal of Pancreas and Biliary Tract.2023; 28(1): 19. CrossRef - Endoscopic Management of Pancreatobiliary Malignancies
Dong Wook Lee, Eun Young Kim
Digestive Diseases and Sciences.2022; 67(5): 1635. CrossRef - Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction
Kojiro Tanoue, Hirotsugu Maruyama, Yuki Ishikawa-Kakiya, Yosuke Kinoshita, Kappei Hayashi, Masafumi Yamamura, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Noriko Kamata, Yasuaki Nagami, Koichi Taira, Toshio Wata
World Journal of Hepatology.2022; 14(5): 993. CrossRef - Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction
Kojiro Tanoue, Hirotsugu Maruyama, Yuki Ishikawa-Kakiya, Yosuke Kinoshita, Kappei Hayashi, Masafumi Yamamura, Masaki Ominami, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Shuhei Hosomi, Fumio Tanaka, Noriko Kamata, Yasuaki Nagami, Koichi Taira, Toshio Wata
World Journal of Hepatology.2022; 14(5): 992. CrossRef - Pancreatic Cancer: Challenges and Opportunities in Locoregional Therapies
Alaa Y. Bazeed, Candace M. Day, Sanjay Garg
Cancers.2022; 14(17): 4257. CrossRef - Endoscopic retrograde cholangiopancreatography: Current practice and future research
David J Sanders, Shivanand Bomman, Rajesh Krishnamoorthi, Richard A Kozarek
World Journal of Gastrointestinal Endoscopy.2021; 13(8): 260. CrossRef - Early malfunction of a biliary self-expandable metal stent with an antireflux valve
Sang Hoon Kim, Chi Hyuk Oh, Jae Min Lee, Seong Ji Choi, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hoon Jai Chun, Hong Sik Lee, Chang Duck Kim
Medicine.2020; 99(16): e19750. CrossRef - Endosonography-guided Radiofrequency Ablation in Pancreatic Diseases
Giuseppe Vanella, Gabriele Capurso, Paolo G. Arcidiacono
Journal of Clinical Gastroenterology.2020; 54(7): 591. CrossRef - Efficacy and safety of radiofrequency ablation in patients with unresectable malignant biliary strictures
Martha Claudia Galindo Orozco, Angélica Hernández Guerrero, Juan Octavio Alonso Larraga, Eduardo Ramírez Solis, José Guillermo de la Mora Levy, María del Carmen Manzano Robleda
Revista Española de Enfermedades Digestivas.2020;[Epub] CrossRef
- International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
- 6,347 View
- 312 Download
- 9 Web of Science
- 12 Crossref
Focused Review Series: Endoscopic approaches to Neuroendocrine Tumors
- Therapy of Pancreatic Neuroendocrine Tumors: Fine Needle Intervention including Ethanol and Radiofrequency Ablation
- Sundeep Lakhtakia
- Clin Endosc 2017;50(6):546-551. Published online November 30, 2017
- DOI: https://doi.org/10.5946/ce.2017.167
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Abstract
PDFPubReaderePub
- Pancreatic neuroendocrine tumors (PNETs) are increasingly being detected, though usually as incidental findings. Majority of the PNETs are non-functional and surgical resection is the standard of care for most of them. However, in patients with small PNETs localized within the pancreas, who are unfit or unwilling for surgery, alternate methods of treatment are needed. Direct methods of ablation of PNETs, using either ethanol injection or radiofrequency ablation (RFA), are emerging as effective methods. The limited literature available as case reports or case series on endoscopic ultrasound (EUS)-guided local ablation using either ethanol or RFA has demonstrated safety and efficacy along with short- to medium-term sustained relief. Long-term benefits with these local ablative therapies are awaited. Comparative studies are needed to show which of these two competing technologies is superior. Finally, comparative trials of EUS-guided ablation with surgical resection in terms of efficacy and safety will ensure their place in the management algorithm.
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Citations
Citations to this article as recorded by- 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
Digestive Endoscopy.2024; 36(4): 395. CrossRef - Efficacy and Safety of Endoscopic Ultrasound-Guided Radiofrequency Ablation for Pancreatic Neuroendocrine Tumors: A Systematic Review and Metanalysis
Elia Armellini, Antonio Facciorusso, Stefano Francesco Crinò
Medicina.2023; 59(2): 359. CrossRef - Chinese expert consensus on multidisciplinary diagnosis and treatment of pancreatic neuroendocrine liver metastases
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Journal of Pancreatology.2023; 6(4): 139. CrossRef - Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms
Giuseppinella Melita, Socrate Pallio, Andrea Tortora, Stefano Francesco Crinò, Antonio Macrì, Gianlorenzo Dionigi
Journal of Clinical Medicine.2021; 10(12): 2638. CrossRef - Sunitinib-Loaded Chondroitin Sulfate Hydrogels as a Novel Drug-Delivery Mechanism for the Treatment of Pancreatic Neuroendocrine Tumors
Xavier M. Keutgen, Kimberly J. Ornell, Alyx Vogle, Olga Lakiza, Jelani Williams, Paul Miller, Katelyn S. Mistretta, Namrata Setia, Ralph R. Weichselbaum, Jeannine M. Coburn
Annals of Surgical Oncology.2021; 28(13): 8532. CrossRef - Study protocol for endoscopic ultrasonography-guided ethanol injection therapy for patients with pancreatic neuroendocrine neoplasm: a multicentre prospective study
Kazuyuki Matsumoto, Hironari Kato, Masayuki Kitano, Kazuo Hara, Masaki Kuwatani, Reiko Ashida, Mamoru Takenaka, Tatsuhiro Yamazaki, Jun Sakurai, Michihiro Yoshida, Hiroyuki Okada
BMJ Open.2021; 11(7): e046505. CrossRef - Long-term outcome after EUS-guided radiofrequency ablation: Prospective results in pancreatic neuroendocrine tumors and pancreatic cystic neoplasms
Marc Barthet, Marc Giovannini, Mohamed Gasmi, Nathalie Lesavre, Christian Boustière, Bertrand Napoleon, Arthur LaQuiere, Stephane Koch, Geoffroy Vanbiervliet, Jean-Michel Gonzalez
Endoscopy International Open.2021; 09(08): E1178. CrossRef - Endoscopic ultrasound-guided ethanol and radiofrequency ablation of pancreatic insulinomas: a systematic literature review
Ghassan El Sayed, Levente Frim, Jamie Franklin, Raymond McCrudden, Charles Gordon, Safa Al-Shamma, Szabolcs Kiss, Péter Hegyi, Bálint Erőss, Péter Jenő Hegyi
Therapeutic Advances in Gastroenterology.2021; 14: 175628482110421. CrossRef - Efficacy and safety of scheduled early endoscopic ultrasonography‐guided ethanol reinjection for patients with pancreatic neuroendocrine tumors: Prospective pilot study
Kazuyuki Matsumoto, Hironari Kato, Seiji Kawano, Hiroyasu Fujiwara, Kenji Nishida, Ryo Harada, Masakuni Fujii, Ryuichi Yoshida, Yuzo Umeda, Shiro Hinotsu, Takahito Yagi, Hiroyuki Okada
Digestive Endoscopy.2020; 32(3): 425. CrossRef - Endoscopic ultrasonography‐guided ethanol ablation of pancreatic neuroendocrine tumors in multiple endocrine neoplasia type 1 disease following complicated total pancreatectomy
Hsiang‐Hung Lin, Chen‐Wang Chang, Ming‐Jen Chen
Advances in Digestive Medicine.2020; 7(2): 97. CrossRef - Interventional endoscopic ultrasound for pancreatic neuroendocrine neoplasms
Mihai Rimbaş, Mihaela Horumbă, Gianenrico Rizzatti, Stefano Francesco Crinò, Antonio Gasbarrini, Guido Costamagna, Alberto Larghi
Digestive Endoscopy.2020; 32(7): 1031. CrossRef - Endoscopic ultrasound-guided radiofrequency ablation for pancreatic neuroendocrine tumor
Marc Barthet
Annales d'Endocrinologie.2019; 80(3): 182. CrossRef - Current Status of Endoscopic Ultrasound Techniques for Pancreatic Neoplasms
Yousuke Nakai, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure, Kazuhiko Koike
Clinical Endoscopy.2019; 52(6): 527. CrossRef
- Safety and efficacy of endoscopic ultrasound‐guided radiofrequency ablation for pancreatic neuroendocrine neoplasms: Systematic review and meta‐analysis
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- 290 Download
- 16 Web of Science
- 13 Crossref
Focused Review Series: Advanced Endoscopic Treatment for Pancreaticobiliary Diseases
- Endoscopic Ablation Therapy for Biliopancreatic Malignancies
- Jason Roque, Shiaw-Hooi Ho, Nageshwar Reddy, Khean-Lee Goh
- Clin Endosc 2015;48(1):15-19. Published online January 31, 2015
- DOI: https://doi.org/10.5946/ce.2015.48.1.15
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Abstract
PDFPubReaderePub
Biliopancreatic malignancies such as cholangiocarcinoma (CCA) has notoriously been diagnosed late. As such most therapy have been palliative in nature. Cholangioscopy allows for an earlier diagnosis to be made. Brachytherapy with the insertion of catheter with iridium-132 seeds, percutaneously or through endoscopic retrograde cholangiopancreatography (ERCP) was the earliest ablative techniques used. It has been shown to have a beneficial effect only in prolonging survival. Photodynamic therapy (PDT) has also been used for several years. stenting with PDT versus stenting alone for unresectable CCA showed a marked survival benefit with the addition of PDT. However the most exciting endoscopic ablative modality appears to be intraductal radiofrequency ablation using the Habib catheter and device. Several case series have shown the effectiveness of this technique in ablating tumors. This technique is evolving and coupled with early diagnosis of CCA through cholangioscopy will allow for a curative therapy. The crux to the effective treatment of early cancerous lesions in the bile or pancreatic duct is the early diagnosis of such lesions. Effective endoscopic ablative therapy is now available with the advent of radiofrequency ablation probes that can be passed through the duodenoscope via ERCP.
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Citations
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