Tringali A, Caiazzo A. Role of endoscopic ultrasound in the treatment of pancreatic neuroendocrine tumors: Lights and shadows of endoscopic ultrasound-guided radiofrequency ablation. World J Gastrointest Endosc 2026; 18(1): 113617 [DOI: 10.4253/wjge.v18.i1.113617]
Corresponding Author of This Article
Alberto Tringali, MD, PhD, Assistant Professor, Chief, Honorary Research Fellow, Lecturer, Department of Digestive Endoscopy and Gastroenterology, Unità Locale di Sanità e Sociale 2, Conegliano Hospital, Via Brigata Bisagno, Conegliano 31015, Veneto, Italy. albtri10@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 16, 2026 (publication date) through Jan 15, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Tringali A, Caiazzo A. Role of endoscopic ultrasound in the treatment of pancreatic neuroendocrine tumors: Lights and shadows of endoscopic ultrasound-guided radiofrequency ablation. World J Gastrointest Endosc 2026; 18(1): 113617 [DOI: 10.4253/wjge.v18.i1.113617]
World J Gastrointest Endosc. Jan 16, 2026; 18(1): 113617 Published online Jan 16, 2026. doi: 10.4253/wjge.v18.i1.113617
Role of endoscopic ultrasound in the treatment of pancreatic neuroendocrine tumors: Lights and shadows of endoscopic ultrasound-guided radiofrequency ablation
Alberto Tringali, Anna Caiazzo
Alberto Tringali, Anna Caiazzo, Department of Digestive Endoscopy and Gastroenterology, Unità Locale di Sanità e Sociale 2, Conegliano Hospital, Conegliano 31015, Veneto, Italy
Author contributions: Tringali A and Caiazzo A wrote the manuscript; Tringali A designed the study and reviewed the manuscript; Caiazzo A created tables and figures. Both authors have approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alberto Tringali, MD, PhD, Assistant Professor, Chief, Honorary Research Fellow, Lecturer, Department of Digestive Endoscopy and Gastroenterology, Unità Locale di Sanità e Sociale 2, Conegliano Hospital, Via Brigata Bisagno, Conegliano 31015, Veneto, Italy. albtri10@gmail.com
Received: August 29, 2025 Revised: September 19, 2025 Accepted: November 24, 2025 Published online: January 16, 2026 Processing time: 138 Days and 17.2 Hours
Abstract
Pancreatic neuroendocrine tumors (pNETs) are a heterogeneous group of pancreatic neoplasms that originate from the endocrine cells of the pancreas, whose prevalence and incidence are constantly increasing worldwide. Based on current knowledge of their natural history, pNETs can be divided into functioning pNET and nonfunctioning pNET tumors, characterized by hormone hypersecretion, which results distinct clinical presentations. Treatment options include observation, medical or surgical therapy, and the choice depends on various factors such as staging and grading of the pancreatic lesion and the presence of a specific hormonal syndrome. Surgical resection has long been considered the gold standard for treatment, with related risks of morbidity and mortality. Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) plays a crucial role as minimally invasive procedure for loco-regional treatment of pNETs in selected patients, showing promising results in terms of clinical outcome. EUS-RFA causes a coagulative necrosis with minimal damage to surrounding tissue, allowing for local ablation. This review summarizes the most recent evidences on the use of EUS-RFA as local ablation therapy describing the main endoscopic steps and providing a critical overview of patient selection criteria, side effects, and long-term outcomes.
Core Tip: In recent years, endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) has become a subject of great interest in Digestive Endoscopy as locoregional treatment for pancreatic neoplastic lesions, particularly for pancreatic neoplastic cysts, pancreatic functional and non-functional neuroendocrine neoplasms and pancreatic ductal adenocarcinoma. The EUS-RFA procedure can potentially ablate these lesions locally in a minimally invasive manner with a very good safety profile. Our focus was to highlight the role of EUS-RFA in the treatment of pancreatic neuroendocrine tumors, based on available evidence, and describe the current potential benefits and limitations of this approach.
