Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2022; 14(2): 533-542
Published online Feb 15, 2022. doi: 10.4251/wjgo.v14.i2.533
Endoscopic ultrasound-guided ablation of solid pancreatic lesions: A systematic review of early outcomes with pooled analysis
Marco Spadaccini, Milena Di Leo, Andrea Iannone, Daan von den Hoff, Alessandro Fugazza, Piera Alessia Galtieri, Gaia Pellegatta, Roberta Maselli, Andrea Anderloni, Matteo Colombo, Peter D Siersema, Silvia Carrara, Alessandro Repici
Marco Spadaccini, Milena Di Leo, Alessandro Fugazza, Piera Alessia Galtieri, Gaia Pellegatta, Roberta Maselli, Andrea Anderloni, Matteo Colombo, Silvia Carrara, Alessandro Repici, Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano 20089, Milan, Italy
Marco Spadaccini, Roberta Maselli, Alessandro Repici, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele 20090, Milan, Italy
Andrea Iannone, Endoscopy Unit, Azienda Ospedale Policlinico, Bari 70124, Italy
Daan von den Hoff, Peter D Siersema, Endoscopy Unit, Radboud University Medical Center, Nijmegen 6525 GA, Netherlands
Author contributions: Spadaccini M drafted the manuscript; Spadaccini M, Di Leo M, Iannone A, Fugazza A, Galtieri PA, Pellegatta G, Maselli R, Anderloni A, Colombo M, Siersema PD, Carrara S, and Repici A conducted the analyses and interpretation of the data; Di Leo M, Iannone A, von den Hoff D, Fugazza A, Galtieri PA, Pellegatta G, Maselli R, Anderloni A, Colombo M, Siersema PD, Carrara S, and Repici A made critical revisions related to the important intellectual content of the manuscript; All authors made substantial contributions to the conception and design of the study, acquisition of data, and final approval of the version of the article to be published.
Conflict-of-interest statement: All the authors declare that they have no competing interests related to the topic.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Silvia Carrara, MD, Doctor, Professor, Endoscopic Unit, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano 20089, Milan, Italy. silvia.carrara@hunimed.eu
Received: February 22, 2021
Peer-review started: February 22, 2021
First decision: April 19, 2021
Revised: April 27, 2021
Accepted: December 31, 2021
Article in press: December 31, 2021
Published online: February 15, 2022
Processing time: 352 Days and 16.8 Hours
Abstract
BACKGROUND

Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is emerging as a complementary therapeutic approach for pancreatic solid masses. However, results of published data are difficult to interpret because of a retrospective design and small sample size.

AIM

To systematically review data on EUS-RFA for solid lesions and to pool the results of the different experiences in order to provide more consistent evidence in terms of safety and efficacy.

METHODS

A comprehensive systematic literature search on the main databases was performed to identify articles in which patients with pancreatic solid lesions underwent EUS-RFA. The primary outcomes were procedure-related adverse events (AEs) and mortality. Secondary outcomes were the technical success rate and the effects on primary tumor growth. Statistical analyses were performed using Stata version 14.0.

RESULTS

In total, 14 studies were included, with 120 patients undergoing 153 ablations of 129 solid pancreatic lesions. The STARmed technology was used in seven studies, the Habib system in six studies, and the HybridTherm probe in one study. The pooled technical success rate was 99.0% (I2: 25.82%). The pooled overall AE rate was 8.0% (I2: 11.46%). Excluding mild AEs, the pooled rates of serious AEs was 1.0% (I2: 0%). No mortality related to the procedure was reported.

CONCLUSION

The present pooled analysis confirms the safety and feasibility of EUS-RFA.

Keywords: Pancreatic cancer; Neuroendocrine tumors; Habib; Cryotechnology; Pancreas; Endoscopic ultrasound

Core Tip: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is emerging as a complementary therapeutic approach for pancreatic solid masses. However, results of published data are difficult to interpret because of a retrospective design and small sample size. Pooling results across 14 published experiences, the technical success rate was 99.0% among over 150 ablations, with an overall adverse event (AE) rate of 8.0%. Excluding mild AEs, the pooled rate of serious AEs was 1.0%, with no mortality. The present pooled analysis confirms the feasibility and safety of EUS-RFA.