Effectiveness and safety of endoscopic ultrasound-guided radiofrequency ablation for pancreatic metastases of renal cell carcinoma.

Background: Pancreatic metastases from renal cell carcinoma (RCC) are usually managed surgically but with significant morbidity. Alternative could be endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) which has shown promising results in the treatment of pancreatic neuroendocrine tumors. Objective: The aim of our study was to assess the technical success, effectiveness, and safety of EUS-RFA in patients with pancreatic metastases of RCC. Methods: This retrospective, observational study included consecutive patients referred for EUS-RFA of pancreatic RCC metastases. EUS-RFA was performed through 18 or 19G dedicated RFA needles. The effectiveness of EUS-RFA treatment was defined by the necrosis with no contrast enhancement or the disappearance of the lesion, determined by contrast enhanced CT scan, at 2 to 5 months post procedure, at one year, and at the end of follow-up. Safety was assessed per and post procedure. Results: Between January 2015 and January 2021, 8 patients with 11 lesions were treated, median time from RCC diagnosis to pancreatic metastases RFA was 8.5 years (1-15). The mean size of the lesions was 13.9 (± 3.9) mm. Technical success assessed by immediate post procedure contrast enhancement or doppler, was 100%. At the first CT scan follow-up, complete response was 45.4% and partial response was 27.3 %. At one-year, complete response was 45.4% and partial response was 27.3%. Three patients had multiple EUS-RFA. Adverse events occurred in 3 patients (mild acute pancreatitis, abdominal pain, and pancreatic fistula with retro-gastric pseudocyst). Conclusion. Our study demonstrated the feasibility and safety of EUS-RFA for patients with pancreatic metastases of RCC.

Publikationsverlauf

Eingereicht: 11. September 2024

Angenommen nach Revision: 25. Januar 2025

Accepted Manuscript online:
25. März 2025