Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. EUS-RFA Procedure
2.3. Prophylaxis and Evaluation of Immediate Complications
2.4. Tumor Response Assessment
3. Results
3.1. Toxicities
3.2. Focal Control and Survival
4. Discussion
4.1. EUS-RFA for Managing Slow Growing Metastases and Avoiding Morbid Surgical Resection
4.2. RFA and Immunotherapy
4.3. Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Baseline Patients’ Characteristics (n = 12) | n | % | ||
---|---|---|---|---|
Left Kidney | n (%) | 6 | 60 | |
Gender | Female n (%) | 6 | 50 | |
TNM | T1/T2 | 9 | 75 | |
T3/T4 | 1 | 8 | ||
Unknown | 2 | 17 | ||
Fuhrman Grade | I/II | 7 | 58 | |
III/IV | 3 | 25 | ||
Unknown | 2 | 17 | ||
IMDC | Good/Intermediate | 4/5 | 33/42 | |
Unknown | 3 | 25 | ||
Systemic Treatment | Before EUS-RFA | VEGFR-TKI/ICI | 4/0 | 33 |
During EUS-RFA | VEGFR-TKI/ICI | 1/1 | 8 | |
After EUS-RFA | VEGFR-TKI/ICI | 3/0 | 25 | |
No systemic treatment | 7 | 58 | ||
Other Metastatic Sites During RCC Evolution | None | 7 | 58 | |
Lung | 5 | 42 | ||
Brain | 1 | 8 | ||
Liver | 2 | 17 | ||
Thyroid | 1 | 8 | ||
Others | 2 | 17 | ||
Median Time from Nephrectomy to 1st Metastasis | Years (range) | 11.6 | (0–22.2) | |
Median Time from Nephrectomy to PM | Years (range) | 13.6 | (0–22.2) | |
Pancreas as the 1st Metastatic Site | n (%) | 9 | 75 | |
Symptoms at PM Presentation | None | 9 | 75 | |
Jaundice | 1 | 8 | ||
Pain | 2 | 17 | ||
PM Localization at Presentation | Head | 7 | 33 | |
Uncus | 4 | 19 | ||
Body | 6 | 29 | ||
Tail | 4 | 19 | ||
Median PM SIZE at Presentation | Millimeters, (range) | 17 | (3–35) | |
Median Number of PM at Presentation (range) | 1 | (1–4) | ||
PM Number at Presentation (n, %) | 1 2 3–4 | 58 17 25 |
Time Point (Evaluable Lesion) | CR (%) | PR (%) | SD (%) | PD (%) | Focal Control Rate (%) | N/E |
---|---|---|---|---|---|---|
2-months (n = 21) | 33.3 | 14.3 | 42.9 | 9.5 | 90.5 | 0 |
6-months (n = 19) | 26.3 | 31.6 | 26.3 | 15.8 | 84.2 | 9.5 |
12-months (n = 15) | 40 | 33.3 | 0 | 26.7 | 73.3 | 28.6 |
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Chanez, B.; Caillol, F.; Ratone, J.-P.; Pesenti, C.; Rochigneux, P.; Pignot, G.; Thomassin, J.; Brunelle, S.; Walz, J.; Salem, N.; et al. Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study. Cancers 2021, 13, 5267. https://doi.org/10.3390/cancers13215267
Chanez B, Caillol F, Ratone J-P, Pesenti C, Rochigneux P, Pignot G, Thomassin J, Brunelle S, Walz J, Salem N, et al. Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study. Cancers. 2021; 13(21):5267. https://doi.org/10.3390/cancers13215267
Chicago/Turabian StyleChanez, Brice, Fabrice Caillol, Jean-Philippe Ratone, Christian Pesenti, Philippe Rochigneux, Géraldine Pignot, Jeanne Thomassin, Serge Brunelle, Jochen Walz, Naji Salem, and et al. 2021. "Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study" Cancers 13, no. 21: 5267. https://doi.org/10.3390/cancers13215267
APA StyleChanez, B., Caillol, F., Ratone, J.-P., Pesenti, C., Rochigneux, P., Pignot, G., Thomassin, J., Brunelle, S., Walz, J., Salem, N., Giovannini, M., & Gravis, G. (2021). Endoscopic Ultrasound-Guided Radiofrequency Ablation as an Future Alternative to Pancreatectomy for Pancreatic Metastases from Renal Cell Carcinoma: A Prospective Study. Cancers, 13(21), 5267. https://doi.org/10.3390/cancers13215267