Expanded Indications and Role of Pancreatic Cyst/Mass Ablation.

PURPOSE OF REVIEW: Despite advances in surgery, chemotherapy, and radiation treatments for pancreatic ductal adenocarcinoma (PDAC), 5-year mortality rates remain high. Although surgery remains the standard of care for pancreatic cancer and precancerous pancreatic lesions, many patients are not considered surgical candidates at the time of diagnosis. Therefore, alternative therapies must be explored for non-surgical patients. This article aims to do a comprehensive literature study and present the most recent information on ablative therapies, particularly endoscopic ultrasound (EUS)-guided RFA (EUS-RFA). RECENT FINDINGS: Emerging literature demonstrates that endoscopic ultrasound (EUS)-guided RFA (EUS-RFA) may reduce both primary and distant tumor growth by modifying the tumor microenvironment, promoting cytokine production, and stimulating immune activation, thereby allowing tumor reduction. Reducing tumor size can allow for surgical intervention and can even serve as an adjunct to chemotherapy or as a palliative measure. The remarkable ability to reduce tumor progression makes RFA a very promising non-surgical therapy technique that has the potential to reduce morbidity and mortality. There are several thermal ablative therapies, including radio non-surgical candidates. Emerging literature demonstrates that endoscopic ultrasound (EUS)-guided RFA (EUS-RFA) may reduce both primary and distant tumor growth by modifying the tumor microenvironment, promoting cytokine production, and stimulating immune activation, thereby allowing tumor reduction. Reducing tumor size can allow for surgical intervention and can even serve as an adjunct to chemotherapy or as a palliative measure. The remarkable ability to reduce tumor progression makes RFA a very promising non-surgical therapy technique that has the potential to reduce morbidity and mortality.