Efficacy and safety of endoscopic ultrasonography-guided ethanol injections of small pancreatic neuroendocrine neoplasms: a prospective multicenter study

Kazuyuki Matsumoto; Hironari Kato; Takao Itoi; Masayuki Kitano; Kazuo Hara; Masaki Kuwatani; Mamoru Takenaka; Reiko Ashida; Shuntaro Mukai; Nozomi Okuno; Kazumichi Kawakubo; Tatsuhiro Yamazaki; Jun Sakurai; Yuki Nakatsuka; Michihiro Yoshida; Motoyuki Otsuka

doi:10.1055/a-2452-4607

Endoscopy, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endoscopy 2025; 57(04): 321-329
DOI: 10.1055/a-2452-4607

Original article

Efficacy and safety of endoscopic ultrasonography-guided ethanol injections of small pancreatic neuroendocrine neoplasms: a prospective multicenter study

Kazuyuki Matsumoto

¹Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)

,

Hironari Kato

¹Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)

,

Takao Itoi

²Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan (Ringgold ID: RIN13112)

,

Masayuki Kitano

³Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan (Ringgold ID: RIN13145)

,

Kazuo Hara

⁴Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan (Ringgold ID: RIN538363)

,

Masaki Kuwatani

⁵Gastroenterology and Hepatology, Hokkaido University Hospital, Hokkaido, Japan (Ringgold ID: RIN163693)

,

Mamoru Takenaka

⁶Gastroenterology and Hepatology, Kindai University Faculty of Medicine Graduate School of Medical Sciences, Osakasayama, Japan (Ringgold ID: RIN38158)

,

Reiko Ashida

³Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan (Ringgold ID: RIN13145)

,

Shuntaro Mukai

²Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan (Ringgold ID: RIN13112)

,

Nozomi Okuno

⁴Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan (Ringgold ID: RIN538363)

,

Kazumichi Kawakubo

⁵Gastroenterology and Hepatology, Hokkaido University Hospital, Hokkaido, Japan (Ringgold ID: RIN163693)

,

Tatsuhiro Yamazaki

¹Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)

,

Jun Sakurai

⁷Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)

,

Yuki Nakatsuka

⁷Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)

,

Michihiro Yoshida

⁷Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)

,

Motoyuki Otsuka

¹Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan (Ringgold ID: RIN92057)

› Institutsangaben

Abstract

Background

Endoscopic ultrasonography (EUS)-guided ethanol injection (EI) has recently been introduced as one of the management strategies for pancreatic neuroendocrine neoplasms (PNENs); however, its role as a surgical alternative is unclear. We evaluated the efficacy and safety of EUS-EI in treating small PNENs through a prospective multicenter study.

Methods

Patients with grade 1 tumors of ≤15 mm confirmed by pathology were included. The primary end point assessed efficacy and safety, measuring complete ablation using computed tomography at 1 and 6 months, prevention of adverse events (AEs) within 1 month, severe pancreatic fistula at 1 month, and incidence/worsening of diabetes mellitus (DM) at 6 months. The composite end point of EUS-EI was compared with that of historical results of a study based on surgical treatment.

Results

25 patients with PNENs, with a median tumor size of 10.1 mm, were treated using EUS-EI. The composite primary end point was achieved by 76.0% of patients (19/25; 95%CI 54.9%–90.6%), a proportion significantly higher than that of surgical treatment (P = 0.008). Regarding efficacy, 88.0% (22/25) of patients achieved complete ablation at 1 and 6 months (95%CI 68.8%–97.5%). Regarding safety, 96.0% (24/25) of patients had no severe AEs within 1 month (95%CI 79.7%–99.9%). No patients had severe pancreatic fistulas at 1 month, and 84.0% (21/25) had no incidence or exacerbation, or both, of DM at 6 months (95%CI 63.9%–95.5%).

Conclusion

EUS-EI is safe and could be a potent treatment option for patients with small PNENs.

Volltext

Referenzen

References
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