Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study

Background: Pancreatic metastases (PM) from renal cell carcinoma (RCC) are rare, are associated with favorable outcomes and are usually handled by surgery or VEGFR inhibitors, which both have side effects. Endoscopic Ultrasound (EUS)-guided radiofrequency ablation (RFA) is an innovative approach to...

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Autores principales:	Brice Chanez, Fabrice Caillol, Jean-Philippe Ratone, Christian Pesenti, Philippe Rochigneux, Géraldine Pignot, Jeanne Thomassin, Serge Brunelle, Jochen Walz, Naji Salem, Marc Giovannini, Gwenaelle Gravis
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	glandular metastases endoscopy radiofrequency ablation renal cell carcinoma pancreatic metastases Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/3b4b71e6bb154cd59d4630c4c2957a8c
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spelling	oai:doaj.org-article:3b4b71e6bb154cd59d4630c4c2957a8c2021-11-11T15:26:44ZEndoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study10.3390/cancers132152672072-6694https://doaj.org/article/3b4b71e6bb154cd59d4630c4c2957a8c2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5267https://doaj.org/toc/2072-6694Background: Pancreatic metastases (PM) from renal cell carcinoma (RCC) are rare, are associated with favorable outcomes and are usually handled by surgery or VEGFR inhibitors, which both have side effects. Endoscopic Ultrasound (EUS)-guided radiofrequency ablation (RFA) is an innovative approach to treat focally deep metastases and could be a relevant technique to control PM from RCC. Methods: This monocentric, prospective study aimed to evaluate the safety and efficacy of EUS-RFA to treat PM. We included patients with confirmed and progressive PM from RCC. PM was ablated under general anesthesia with a linear EUS scope and a EUS-RFA 19-gauge needle electrode placed into the tumor. Results: Twelve patients from Paoli-Calmettes Institute were recruited between May 2017 and December 2019. Median age was 70.5 years (range 61–75), 50% were female, 100% were ECOG 0–1. At inclusion, mean PM size was 17 mm (range 3–35 mm); and all were progressive before EUS-RFA. Seven patients had EUS-RFA as the only treatment for RCC. We performed 26 EUS-RFA procedures and 21 PM was ablated. Median follow up was 27.7 months (range 6.4–57.1). For evaluable PM, the 6- and 12-month focal control rates were 84% and 73% respectively. One patient treated with TKI developed a paraduodenal abscess 2 months after EUS-RFA and another patient with biliary stent developed hepatic abscesses few days after EUS-RFA. No other severe side effects were experienced. Conclusions: in this series, which is the largest ever reported, we showed that EUS-RFA is feasible and yields an excellent local control rate for PM from mRCC. With manageable complications, it could be a valuable alternative to pancreatic surgery in well-selected patients.Brice ChanezFabrice CaillolJean-Philippe RatoneChristian PesentiPhilippe RochigneuxGéraldine PignotJeanne ThomassinSerge BrunelleJochen WalzNaji SalemMarc GiovanniniGwenaelle GravisMDPI AGarticleglandular metastasesendoscopyradiofrequency ablationrenal cell carcinomapancreatic metastasesNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5267, p 5267 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	glandular metastases endoscopy radiofrequency ablation renal cell carcinoma pancreatic metastases Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	glandular metastases endoscopy radiofrequency ablation renal cell carcinoma pancreatic metastases Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Brice Chanez Fabrice Caillol Jean-Philippe Ratone Christian Pesenti Philippe Rochigneux Géraldine Pignot Jeanne Thomassin Serge Brunelle Jochen Walz Naji Salem Marc Giovannini Gwenaelle Gravis Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study
description	Background: Pancreatic metastases (PM) from renal cell carcinoma (RCC) are rare, are associated with favorable outcomes and are usually handled by surgery or VEGFR inhibitors, which both have side effects. Endoscopic Ultrasound (EUS)-guided radiofrequency ablation (RFA) is an innovative approach to treat focally deep metastases and could be a relevant technique to control PM from RCC. Methods: This monocentric, prospective study aimed to evaluate the safety and efficacy of EUS-RFA to treat PM. We included patients with confirmed and progressive PM from RCC. PM was ablated under general anesthesia with a linear EUS scope and a EUS-RFA 19-gauge needle electrode placed into the tumor. Results: Twelve patients from Paoli-Calmettes Institute were recruited between May 2017 and December 2019. Median age was 70.5 years (range 61–75), 50% were female, 100% were ECOG 0–1. At inclusion, mean PM size was 17 mm (range 3–35 mm); and all were progressive before EUS-RFA. Seven patients had EUS-RFA as the only treatment for RCC. We performed 26 EUS-RFA procedures and 21 PM was ablated. Median follow up was 27.7 months (range 6.4–57.1). For evaluable PM, the 6- and 12-month focal control rates were 84% and 73% respectively. One patient treated with TKI developed a paraduodenal abscess 2 months after EUS-RFA and another patient with biliary stent developed hepatic abscesses few days after EUS-RFA. No other severe side effects were experienced. Conclusions: in this series, which is the largest ever reported, we showed that EUS-RFA is feasible and yields an excellent local control rate for PM from mRCC. With manageable complications, it could be a valuable alternative to pancreatic surgery in well-selected patients.
format	article
author	Brice Chanez Fabrice Caillol Jean-Philippe Ratone Christian Pesenti Philippe Rochigneux Géraldine Pignot Jeanne Thomassin Serge Brunelle Jochen Walz Naji Salem Marc Giovannini Gwenaelle Gravis
author_facet	Brice Chanez Fabrice Caillol Jean-Philippe Ratone Christian Pesenti Philippe Rochigneux Géraldine Pignot Jeanne Thomassin Serge Brunelle Jochen Walz Naji Salem Marc Giovannini Gwenaelle Gravis
author_sort	Brice Chanez
title	Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study
title_short	Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study
title_full	Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study
title_fullStr	Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study
title_full_unstemmed	Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study
title_sort	endoscopic ultrasound-guided radiofrequency ablation as an future alternative to pancreatectomy for pancreatic metastases from renal cell carcinoma: a prospective study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3b4b71e6bb154cd59d4630c4c2957a8c
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Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study

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