Endoscopic Ultrasound

REVIEW ARTICLE
Year
: 2022  |  Volume : 11  |  Issue : 3  |  Page : 170--185

EUS-guided radiofrequency and ethanol ablation for pancreatic neuroendocrine tumors: A systematic review and meta-analysis


Rajat Garg1, Abdul Mohammed1, Amandeep Singh1, Mary P Harnegie2, Tarun Rustagi3, Tyler Stevens1, Prabhleen Chahal1 
1 Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, Ohio, USA
2 Cleveland Clinic Alumni Library, Cleveland Clinic, Cleveland, Ohio, USA
3 Department of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, New Mexico, USA

Correspondence Address:
Rajat Garg
Department of Gastroenterology, Hepatology and Nutrition, 9500 Euclid Avenue, Cleveland Clinic Foundation, Cleveland 44195, Ohio
USA

EUS-guided radiofrequency ablation (RFA) and ethanol ablation (EA) for pancreatic neuroendocrine tumors (PNETs) have recently been reported with good outcomes. We performed a systematic review and meta-analysis to evaluate the comparative effectiveness and safety of EUS-RFA and EUS-EA in the treatment of PNETs. A comprehensive search of multiple databases (through October 2020) was performed to identify studies that reported outcomes of EUS-RFA and EUS-EA of PNETs. Outcomes assessed included clinical success, technical success, and adverse events (AEs). A total of 181 (100 EUS-RFA, 81 EUS-EA) patients (60.7 ± 9.2 years) with 204 (113 EUS-RFA, 91 EUS-EA) PNETs (mean size 15.1 ± 4.7 mm) were included from 20 studies. There was no significant difference in the rates of technical success (94.4% [95% confidence interval (CI): 88.5–97.3, I2 = 0] vs. 96.7% [95% CI: 90.8–98.8, I2 = 0]; P = 0.42), clinical success (85.2% (95% CI: 75.9–91.4, I2 = 0) vs. 82.2% [95% CI: 68.2–90.8, I2 = 10.1]; P = 0.65), and AEs (14.1% [95% CI: 7.1–26.3, I2 = 0] vs. 11.5% [95% CI: 4.7–25.4, I2 = 63.5]; P = 0.7) between EUS-RFA and EUS-EA, respectively. The most common AE was pancreatitis with the rate of 7.8% and 7.6% (P = 0.95) for EUS-RFA and EUS-EA, respectively. On meta-regression, the location of PNETs in head/neck of pancreas (P = 0.03) was a positive predictor of clinical success for EUS-RFA. EUS-RFA and EUS-EA have similar effectiveness and safety for PNETs ablation. Head/neck location of PNETs was a positive predictor for clinical success after EUS-RFA.


How to cite this article:
Garg R, Mohammed A, Singh A, Harnegie MP, Rustagi T, Stevens T, Chahal P. EUS-guided radiofrequency and ethanol ablation for pancreatic neuroendocrine tumors: A systematic review and meta-analysis.Endosc Ultrasound 2022;11:170-185


How to cite this URL:
Garg R, Mohammed A, Singh A, Harnegie MP, Rustagi T, Stevens T, Chahal P. EUS-guided radiofrequency and ethanol ablation for pancreatic neuroendocrine tumors: A systematic review and meta-analysis. Endosc Ultrasound [serial online] 2022 [cited 2022 Jul 3 ];11:170-185
Available from: http://www.eusjournal.com/article.asp?issn=2303-9027;year=2022;volume=11;issue=3;spage=170;epage=185;aulast=Garg;type=0