Radiofrequency ablation of pancreatic neuroendocrine tumors: a pilot study of feasibility, efficacy, and safety.
OBJECTIVE
This study aimed to assess the feasibility, safety, and efficacy of radiofrequency ablation (RFA) of pancreatic neuroendocrine tumors (PNETs).


METHODS
We performed RFA on 10 patients (7 women) aged 38 to 75 years with histologically diagnosed PNETs (secreting in 3 cases) who could not or would not undergo surgical resection. Tumor nodules (diameter, 0.9-2.9 cm; mean [SD], 1.6 [0.5] cm) were located in the head (n = 7) or body (n = 3) of the pancreas. Ultrasound-guided RFA was performed percutaneously (n = 7), endoscopically (n = 1), or intraoperatively (n = 2) using commercially available equipment. Complete ablation was defined as absence of enhancing tissue at the tumor site on contrast-enhanced imaging studies and normalization of previously elevated serum hormone levels.


RESULTS
Complete ablation was achieved with 1 (n = 9) or 2 (n = 1) RFA procedures. All neuroendocrine syndromes regressed within 24 hours of treatment. No recurrences were observed during follow-up (range, 12-60 months; median [SD], 34 [14] months). No deaths occurred. Major complications included acute pancreatitis in 3 patients, 2 of whom developed pancreatic fluid collections that were successfully managed with ultrasound-guided drainage and endoscopy.


CONCLUSIONS
Radiofrequency ablation is a feasible, safe, and effective option for patients with small PNETs who cannot or do not want to undergo surgical resection.
From the *VI Department of Internal Medicine, Policlinico San Matteo Foundation; and Departments of †Surgical Sciences, and ‡Radiology, University of Pavia, Pavia, Italy.
Sandro
S
Rossi
Francesca Torello
FT
Viera
Giorgia
G
Ghittoni
Lorenzo
L
Cobianchi
Laura Lavinia
LL
Rosa
Luisa
L
Siciliani
Chandra
C
Bortolotto
Letizia
L
Veronese
Alessandro
A
Vercelli
Anna
A
Gallotti
Valentina
V
Ravetta
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000601:surgery*; D010179:Pancreas / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010865:Pilot Projects; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods