Expanded indication for EUS-guided radiofrequency ablation: management of adrenal tumors

Sung Hyun Cho; Dae Hyeon Kim; Dong-Wan Seo; Seul Ki Yoo; Dongwook Oh; Tae Jun Song; Sung Koo Lee

doi:10.1016/j.gie.2023.06.011

Expanded indication for EUS-guided radiofrequency ablation: management of adrenal tumors

Gastrointest Endosc. 2023 Nov;98(5):790-796. doi: 10.1016/j.gie.2023.06.011. Epub 2023 Jun 23.

Authors

Sung Hyun Cho¹, Dae Hyeon Kim², Dong-Wan Seo³, Seul Ki Yoo¹, Dongwook Oh¹, Tae Jun Song¹, Sung Koo Lee¹

Affiliations

¹ Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
² University of Ulsan College of Medicine, Seoul, South Korea.
³ Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: dwseoamc@amc.seoul.kr.

PMID: 37356635
DOI: 10.1016/j.gie.2023.06.011

Abstract

Background and aims: EUS-guided radiofrequency ablation (EUS-RFA) has been performed as an alternative to surgery for the treatment of pancreatic tumors. The promising results obtained using this procedure suggest that the indication for EUS-RFA could be expanded to the management of extrapancreatic tumors. Here, we evaluate the feasibility, efficacy, and safety of EUS-RFA in the treatment of left adrenal tumors.

Methods: This single-center, prospective study was conducted at Asan Medical Center between January 2016 and November 2021. A total of 11 patients with left adrenal tumors were enrolled in the study. The technical success rate, treatment response, and adverse events were evaluated.

Results: EUS-RFA was performed successfully in all patients (technical success rate, 100%). The indications for the procedure were an increase in tumor size (n = 8), and adrenal tumor with adrenal hormone excess (n = 3). After a median of 2 EUS-RFA sessions (range, 1-2), 73% of patients had a complete response, and 27% had a partial response. During follow-up, 5 patients experienced self-limiting mild abdominal pain; no moderate or severe adverse events were reported.

Conclusions: EUS-RFA showed high technical feasibility, clinical success, and an acceptable safety profile in the treatment of left adrenal tumors. In patients at high surgical risk, EUS-RFA can be considered as an alternative therapeutic modality to surgery for the treatment of left adrenal tumors.