Surgery has been regarded as the only curative treatment for patients with small nonfunctional pancreatic neuroendocrine neoplasms (NF-PNENs) less than 2 cm. Due to the significant adverse event rates of surgery, the European Neuroendocrine Tumor Society issued guidelines favoring surveillance for those patients lacking criteria suggestive of an aggressive disease. Despite the above recommendations, a significant proportion of small NF-PNEN patients still undergo surgery. Recently, several studies have reported the safety and effectiveness of EUS-guided radiofrequency ablation (RFA) for the treatment of small NF-PNENs. The experience with EUS-RFA is, however, limited, but published results indicate a potential role as a minimally invasive alternative treatment for these patients, in particular in those in whom further progression is more probable, before they reach the absolute need for surgery. A step-up approach with EUS-RFA followed by surgery for the failure cases can become a valid option to be validated in clinical studies.

Small nonfunctional pancreatic neuroendocrine neoplasms. Time for a step-up treatment approach? / Rimbaş, Mihai; Rizzatti, Gianenerico; Tosoni, Alberto; Impagnatiello, Michele; Panzuto, Francesco; Larghi, Alberto. - In: ENDOSCOPIC ULTRASOUND. - ISSN 2303-9027. - 12:1(2023), pp. 1-7. [10.4103/EUS-D-22-00028]

Small nonfunctional pancreatic neuroendocrine neoplasms. Time for a step-up treatment approach?

Impagnatiello, Michele;Panzuto, Francesco;
2023

Abstract

Surgery has been regarded as the only curative treatment for patients with small nonfunctional pancreatic neuroendocrine neoplasms (NF-PNENs) less than 2 cm. Due to the significant adverse event rates of surgery, the European Neuroendocrine Tumor Society issued guidelines favoring surveillance for those patients lacking criteria suggestive of an aggressive disease. Despite the above recommendations, a significant proportion of small NF-PNEN patients still undergo surgery. Recently, several studies have reported the safety and effectiveness of EUS-guided radiofrequency ablation (RFA) for the treatment of small NF-PNENs. The experience with EUS-RFA is, however, limited, but published results indicate a potential role as a minimally invasive alternative treatment for these patients, in particular in those in whom further progression is more probable, before they reach the absolute need for surgery. A step-up approach with EUS-RFA followed by surgery for the failure cases can become a valid option to be validated in clinical studies.
2023
eus; non-functional; pancreatic neuroendocrine neoplasms; radiofrequency ablation; step-up treatment; surgery
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Small nonfunctional pancreatic neuroendocrine neoplasms. Time for a step-up treatment approach? / Rimbaş, Mihai; Rizzatti, Gianenerico; Tosoni, Alberto; Impagnatiello, Michele; Panzuto, Francesco; Larghi, Alberto. - In: ENDOSCOPIC ULTRASOUND. - ISSN 2303-9027. - 12:1(2023), pp. 1-7. [10.4103/EUS-D-22-00028]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1662698
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