Frontiers in endocrinology · 2026
Clinical outcomes of medical therapy, EUS-guided ethanol ablation, and surgical resection in insulinoma: a clinical epidemiology study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lu Jin-Ying, Chou Fan, Cheng Tsu-Yao, Wen Fang-Yu, Tien Yu-Wen, Kuo Ting-Chun, Chang Chin-Chen, Wu Wan-Chen, Chiu Wei-Yi, Shih Shyang-Rong, Chen Pei-Lung, Wang Chih-Yuan, Wang Hsiu-Po, Hu Fu-Chang
Аннотация
INTRODUCTION: Insulinoma is a rare pancreatic neuroendocrine tumor causing hypoglycemia. Surgery is the standard treatment, while endoscopic ultrasound (EUS)-guided ethanol ablation and medical therapy are alternatives in some patients.
METHODS: In this retrospective study, we recruited 19 patients with insulinoma treated between 2011 and 2025 at National Taiwan University Hospital. The final treatment strategies were surgery (n = 13), EUS-guided ethanol ablation (n = 3), and medical therapy (n = 3). The study outcomes included post-procedure stays (PPS), treatment-related complications, and follow-up results. New-onset diabetes and complete remission rates for insulinoma were examined and compared across treatment modalities. A Firth's bias-reduced logistic regression analysis was performed to identify predictors of complete remission in 19 patients with insulinoma.
RESULTS: Patients could receive more than one treatment. Among the three final treatment modalities, surgical resection achieved the highest complete remission rate (13/13; 100%) but was associated with a longer PPS (mean ± standard deviation [SD] = 13.46 ± 7.59 days) and a higher incidence of new-onset diabetes (2/13, 15.38%). EUS-guided ethanol ablation demonstrated moderate efficacy (2/3; 66.67%) with a comparable PPS (18.33 ± 27.43 days). Lastly, medical therapy relieved symptoms but yielded no complete remissions in insulinoma (0/3; 0%). Paradoxical hypoglycemia occurred in 2 of 8 patients (25.0%) during octreotide testing or after direct octreotide treatment. One patient with insulin autoimmune syndrome improved after drug withdrawal and multimodal therapy. Logistic regression analysis identified a positive linear effect of baseline glucose levels (mg/dL) on insulinoma complete remission (estimated adjusted odds ratio [aOR] = 1.2140, p = 0.0461) and ever surgery (yes vs. no) as the most effective treatment for complete remission in insulinoma (aOR = 296.0707, p = 0.0015).
CONCLUSION: Although surgery was the most effective treatment, it was associated with longer recovery times and potential metabolic risks. EUS-guided ethanol ablation provided a less invasive alternative with a moderate success rate, whereas medical therapy primarily offered symptomatic control rather than a definitive complete remission. Notably, lower baseline glucose levels were associated with treatment resistance, suggesting a potential role in guiding individualized therapeutic strategies.
METHODS: In this retrospective study, we recruited 19 patients with insulinoma treated between 2011 and 2025 at National Taiwan University Hospital. The final treatment strategies were surgery (n = 13), EUS-guided ethanol ablation (n = 3), and medical therapy (n = 3). The study outcomes included post-procedure stays (PPS), treatment-related complications, and follow-up results. New-onset diabetes and complete remission rates for insulinoma were examined and compared across treatment modalities. A Firth's bias-reduced logistic regression analysis was performed to identify predictors of complete remission in 19 patients with insulinoma.
RESULTS: Patients could receive more than one treatment. Among the three final treatment modalities, surgical resection achieved the highest complete remission rate (13/13; 100%) but was associated with a longer PPS (mean ± standard deviation [SD] = 13.46 ± 7.59 days) and a higher incidence of new-onset diabetes (2/13, 15.38%). EUS-guided ethanol ablation demonstrated moderate efficacy (2/3; 66.67%) with a comparable PPS (18.33 ± 27.43 days). Lastly, medical therapy relieved symptoms but yielded no complete remissions in insulinoma (0/3; 0%). Paradoxical hypoglycemia occurred in 2 of 8 patients (25.0%) during octreotide testing or after direct octreotide treatment. One patient with insulin autoimmune syndrome improved after drug withdrawal and multimodal therapy. Logistic regression analysis identified a positive linear effect of baseline glucose levels (mg/dL) on insulinoma complete remission (estimated adjusted odds ratio [aOR] = 1.2140, p = 0.0461) and ever surgery (yes vs. no) as the most effective treatment for complete remission in insulinoma (aOR = 296.0707, p = 0.0015).
CONCLUSION: Although surgery was the most effective treatment, it was associated with longer recovery times and potential metabolic risks. EUS-guided ethanol ablation provided a less invasive alternative with a moderate success rate, whereas medical therapy primarily offered symptomatic control rather than a definitive complete remission. Notably, lower baseline glucose levels were associated with treatment resistance, suggesting a potential role in guiding individualized therapeutic strategies.