Long-term clinical and radiological outcomes of endoscopic ultrasound-guided radiofrequency ablation of benign insulinomas

Zoé Debraine; Ivan Borbath; Pierre Deprez; Florence Bosly; Dominique Maiter; Raluca M Furnica

doi:10.1111/cen.14981

Long-term clinical and radiological outcomes of endoscopic ultrasound-guided radiofrequency ablation of benign insulinomas

Clin Endocrinol (Oxf). 2023 Oct 20. doi: 10.1111/cen.14981. Online ahead of print.

Authors

Zoé Debraine¹, Ivan Borbath², Pierre Deprez², Florence Bosly³, Dominique Maiter¹, Raluca M Furnica¹

Affiliations

¹ Division of Endocrinology and Nutrition, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium.
² Division of Hepatogastroenterology, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium.
³ Division of Endocrinology, Clinique Vivalia, Arlon Hospital, Arlon, Belgium.

PMID: 37859570
DOI: 10.1111/cen.14981

Abstract

Objective: In recent years, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has emerged as an alternative nonsurgical treatment for pancreatic neuroendocrine tumours. The aim of our study was to assess the long-term follow-up of patients treated with EUS-RFA for a sporadic insulinoma in our centre in terms of efficacy, safety and risk of recurrence.

Design, patients and measurements: We retrospectively analysed the data of 11 patients with an insulinoma treated by EUS-RFA in our tertiary centre between June 2018 and April 2022. Clinical and biological, as well as imaging, follow-up was planned at 3, 6, 12 months and then annually.

Results: In our series, there were nine women and two men with a median age of 65 years. All tumours were sporadic, with a mean size of 11 mm. The procedure allowed an immediate and complete symptomatic and biological remission in all patients without notable complications. Complete radiological resolution of the tumour after ablation was observed in seven patients, and persistence of an asymptomatic tumour residue was observed in four patients. During the mean follow-up period of 26 months, two patients presented a significant but asymptomatic increase of the tumour residue; a second EUS-RFA session was performed in one patient and the other patient is being closely monitored.

Conclusions: EUS-RFA treatment of benign insulinomas provides a long-term complete clinical resolution of hypoglycaemia. A long-term follow-up is essential if residual tumour persists after initial EUS-RFA treatment.

Keywords: efficacy; endoscopic ultrasound-guided radiofrequency ablation; insulinoma; long-term follow-up; residual tumour; risk of recurrence; safety.