EUS-RFA for Small Nonfunctioning PanNETs: GIE | September 2026

What Did the Study Find?

This 7-center study evaluated EUS-guided radiofrequency ablation (EUS-RFA) in 46 patients with biopsy-proven nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs), predominantly small, well-differentiated grade 1 lesions.

Technical success was 100%; mean tumor size was 12.7 mm.

Initial complete and partial responses were 33% and 48%, respectively.

Many incomplete responders underwent repeat RFA.

At 15.7 months, cumulative complete response reached 60%, with another 31% achieving partial response.

Longer RFA probes and more applications were associated with complete response.

Adverse events occurred in 15%, including mild pancreatitis and one grade III bleed.

Why Does It Matter?

Small NF-PanNETs create a management dilemma between surveillance and potentially morbid pancreatic surgery. EUS-RFA offers a minimally invasive, organ-preserving alternative for carefully selected patients.

GastroAGI Takeaway

EUS-RFA is promising, but not yet a replacement for surgery or surveillance standards. The 60% complete response was cumulative, frequently requiring retreatment, and comes from a small retrospective cohort. Prospective studies with longer oncologic follow-up are needed before routine adoption.