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Endoscopic Radiofrequency Ablation Excels for Pancreatic Tumors

Key clinical point: Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is an attractive emerging option for treatment of patients with unresectable pancreatic tumors.

Major finding: EUS-RFA had an 84.5% clinical success rate and reassuring safety profile for treatment of unresectable malignant and benign pancreatic tumors.

Study details: This was a meta-analysis of 13 published studies of EUS-RFA therapy applied to 127 patients with unresectable pancreatic tumors.

Disclosures: The presenter reported no financial conflicts regarding his study, conducted free of commercial support.


Dhaliwal A. ACG 2019 Abstract 30.


Frequently, by the time a pancreatic tumor is diagnosed, surgical resection of the tumor is no longer feasible. Current surgical techniques for pancreatic tumor resection have significant toxicity; therefore, resection of tumors considered “borderline” likely results in more toxicity than benefit. In this abstract, Dhaliwal et al describe a systematic review and meta-analysis of studies that report the evaluation of endoscopic radiofrequency ablation (RFA) in pancreatic tumors. The primary outcome of the study was the technical (successful placement of the needle within the lesion) and clinical (decrease in size of lesion, improvement of symptoms, and radiological evidence of necrosis) success. They identified 13 studies that included 127 patients. The pooled technical success rate was 98% while the clinical success rate was 89%. While the number of patients is small, and only about two-thirds had adenocarcinoma, the results suggest that RFA should be further studied in pancreatic tumors.—Mark A. Klein, MD