Endoscopic Ultrasound Guided Radio Frequency Ablation of Pancreatic Neuroendocrine Neoplasms

Endoscopic Ultrasound Guided Radio Frequency Ablation of Pancreatic Neuroendocrine Neoplasms

A national multicenter prospective study to investigate the feasibility and efficacy of endoscopic ultrasound guided radiofrequency ablation of neuroendocrine pancreatic tumors, WHO Grade 1-2 of 3 cm or less in diameter.

Inclusion Criteria:

• Age above 18
• EUS fine needle biopsy (FNB) proven pancreatic neuroendocrine tumor (PNET), WHO 2019 Grade 1-2 in patients with functioning or non-functioning tumors. Also

MEN1 patients are eligible:

• PNET 2-3 cm in largest diameter (Based on MRI or CT) with a Ki-67 <5%, or:

  • PNET < 2cm with Ki-67 <10% that has shown progression during surveillance, or:
  • PNET 1.5-2 cm with Ki-67 <10% in patients age < 60 years of age, whether progression is detected or not.

• Distance from the main pancreatic duct ≥2 mm, or <2mm with a prophylactic stent in the main pancreatic duct.

• Patient in good general condition, ECOG performance status 0-2 (see Appendix)

• Signed written informed consent

Exclusion Criteria:

• Pregnancy.
• Life expectancy < 1 year
• Severe hemostasis disorders
• Pancreatic and/or biliary ductal dilation
• Evidence of active pancreatitis
• Metastatic disease, including local lymph node metastases
• Use of anticoagulants that cannot be discontinued
• INR >1.5 or platelet count <50.00
• Distance from the main pancreatic duct <1 mm, and placement of a pancreatic stent is not possible
• Patient being managed for another malignant lesion which is progressive or under treatment