Endoscopic Ultrasonography-Guided Ethanol Ablation for Small Pancreatic Neuroendocrine Tumors: Results of a Pilot Study

• Published in: Clinical endoscopy Vol. 48; no. 2; pp. 158 - 164
• Main Authors: Park, Do Hyun, Choi, Jun-Ho, Oh, Dongwook, Lee, Sang Soo, Seo, Dong-Wan, Lee, Sung Koo, Kim, Myung-Hwan
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Gastrointestinal Endoscopy 01.03.2015; 대한소화기내시경학회
• Subjects: Original; 내과학; Endosonography; Ethanol; Ablation; Neuroendocrine tumors
• ISSN: 2234-2400; 2234-2443
• DOI: 10.5946/ce.2015.48.2.158

Endoscopic ultrasonography (EUS)-guided ethanol ablation is gaining popularity for the treatment of focal pancreatic lesions. The aim of this study was to evaluate the safety, feasibility, and treatment response after EUS-guided ethanol injection for small pancreatic neuroendocrine tumors (p-NETs). This was a retrospective analysis of a prospectively collected database including 11 consecutive patients with p-NETs who underwent EUS-guided ethanol injection. EUS-guided ethanol injection was successfully performed in 11 patients with 14 tumors. The final diagnosis was based on histology and clinical signs as follows: 10 non-functioning neuroendocrine tumors and four insulinomas. During follow-up (median, 370 days; range, 152 to 730 days), 10 patients underwent clinical follow-up after treatment, and one patient was excluded because of loss to follow-up. A single treatment session with an injection of 0.5 to 3.8 mL of ethanol resulted in complete responses (CRs) at the 3-month radiologic imaging for seven of 13 tumors (response rate, 53.8%). Multiple treatment sessions performed in three tumors with residual viable enhancing tissue increased the number of tumors with CRs to eight of 13 (response rate, 61.5%). Mild pancreatitis occurred in three of 11 patients. EUS-guided ethanol injection appears to be a safe, feasible, and potentially effective method for treating small p-NETs in patients who are poor surgical candidates.