EUS-guided radiofrequency ablation for intraductal papillary mucinous neoplasms with worrisome features : long-term outcomes in non-surgical patients.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
3 patients, including one case necrotizing pancreatitis; there were no procedure-related deaths.
I · Intervention 중재 / 시술
EUS-RFA for BD-IPMNs with WF/HRS at a tertiary referral center (2015-2024)
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
These results support EUS-RFA as a promising therapeutic option in carefully selected patients. Larger prospective studies are needed to refine selection criteria and confirm long-term oncologic benefit.
[BACKGROUND AND AIMS] Branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) are precancerous cystic lesions.
APA
Barras J, Lorenzo D, et al. (2026). EUS-guided radiofrequency ablation for intraductal papillary mucinous neoplasms with worrisome features : long-term outcomes in non-surgical patients.. Gastrointestinal endoscopy. https://doi.org/10.1016/j.gie.2026.03.025
MLA
Barras J, et al.. "EUS-guided radiofrequency ablation for intraductal papillary mucinous neoplasms with worrisome features : long-term outcomes in non-surgical patients.." Gastrointestinal endoscopy, 2026.
PMID
41903818
Abstract
[BACKGROUND AND AIMS] Branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) are precancerous cystic lesions. Surgery is advised for high-risk stigmata (HRS) or multiple worrisome features (WF) but entails substantial morbidity, and many resections reveal only low-grade dysplasia. Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is a minimally invasive alternative, yet long-term data are limited.
[METHODS] We retrospectively analyzed a prospectively maintained cohort of consecutive patients who underwent EUS-RFA for BD-IPMNs with WF/HRS at a tertiary referral center (2015-2024). Eligible patients were inoperable or declined surgery. Outcomes included technical success, adverse events (AEs), local control (resolution of WF/HRS with no cancer arising from the treated lesion), radiologic response, and pancreas-wide events.
[RESULTS] Fifty patients (62 procedures; 58 lesions) were treated. Mean follow-up was 4.1±2.8 years after RFA (9 years from IPMN diagnosis). Technical success was 100%. AEs occurred in 27% of procedures, mostly mild abdominal pain; post-procedural pancreatitis occurred in 3 patients, including one case necrotizing pancreatitis; there were no procedure-related deaths. Local control was achieved in 98% of lesions; 17% showed complete radiologic disappearance and 86% decreased in size. No treated lesion progressed to cancer. Pancreas-wide disease control was maintained in 80% of patients; four (8%) developed pancreatic cancer remote from the treated cyst. Smaller cyst size and fewer WF were associated with better outcomes.
[CONCLUSION] EUS-RFA is feasible, safe, and provides durable local control of BD-IPMNs with WF/HRS in patients unsuitable for surgery or declining resection. These results support EUS-RFA as a promising therapeutic option in carefully selected patients. Larger prospective studies are needed to refine selection criteria and confirm long-term oncologic benefit.
[METHODS] We retrospectively analyzed a prospectively maintained cohort of consecutive patients who underwent EUS-RFA for BD-IPMNs with WF/HRS at a tertiary referral center (2015-2024). Eligible patients were inoperable or declined surgery. Outcomes included technical success, adverse events (AEs), local control (resolution of WF/HRS with no cancer arising from the treated lesion), radiologic response, and pancreas-wide events.
[RESULTS] Fifty patients (62 procedures; 58 lesions) were treated. Mean follow-up was 4.1±2.8 years after RFA (9 years from IPMN diagnosis). Technical success was 100%. AEs occurred in 27% of procedures, mostly mild abdominal pain; post-procedural pancreatitis occurred in 3 patients, including one case necrotizing pancreatitis; there were no procedure-related deaths. Local control was achieved in 98% of lesions; 17% showed complete radiologic disappearance and 86% decreased in size. No treated lesion progressed to cancer. Pancreas-wide disease control was maintained in 80% of patients; four (8%) developed pancreatic cancer remote from the treated cyst. Smaller cyst size and fewer WF were associated with better outcomes.
[CONCLUSION] EUS-RFA is feasible, safe, and provides durable local control of BD-IPMNs with WF/HRS in patients unsuitable for surgery or declining resection. These results support EUS-RFA as a promising therapeutic option in carefully selected patients. Larger prospective studies are needed to refine selection criteria and confirm long-term oncologic benefit.