Table 1.
Summary of Results for Selected Studies Utilizing EUS-Guided EA for PCN Therapy.
| Author | Study Year | Ablative Strategy | Number of Treated Patients | Number of Treated Lesions | Efficacy on Follow-Up Imaging **, n (%) | Adverse Events, (n) | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| MCN | IPMN | Other * | Incomplete Response | Partial Response | Complete Response | |||||
| Gan et al. [5] | 2005 | Ethanol (5–80%) |
25 | 14 | 3 | 6 | 13 (56) | 2 (9) | 8 (35) | None |
| DeWitt et al. [59] | 2009 | Ethanol (80%) |
25 | 10 | 10 | 5 | 13 (59) | 0 (0) | 9 (41) | Mild abdominal pain (7); Intra-cystic bleeding (1); Acute pancreatitis (1) |
| Saline | 17 *** | 7 | 7 | 3 | 11 (79) | 0 (0) | 3 (21) **** | Mild abdominal pain (3) | ||
| DiMaio et al. [56] | 2011 | Ethanol (80%) |
13 | 0 | 13 | 0 | 8 (62) | 0 (0) | 5 (38) | Mild abdominal pain (1) |
| Caillol et al. [24] | 2012 | Ethanol (99%) |
13 | 14 | 0 | 0 | 2 (15) | 0 (0) | 11 (85) | None |
| Gómez et al. [57] | 2016 | Ethanol (80%) |
23 | 4 | 15 | 4 | 11 (48) | 10 (43) | 2 (9) | Mild abdominal pain (1): Acute pancreatitis (1) |
| Park et al. [58] | 2016 | Ethanol (99%) |
91 | 12 | 9 | 70 | 13 (14) | 37 (41) | 41 (45) | Mild abdominal pain (18); Fever without infection (8); Acute pancreatitis (3) |
* The designation of “Other” includes patients treated in the above studies for cystic lesions that are non-neoplastic (i.e., pseudocysts), neoplastic without malignant potential (i.e., SCNs), or indeterminate based on pre-procedural analysis. Although the scope of this review focuses on the use of EUS-guided ablative procedures in the treatment of neoplastic cysts capable of malignant transformation (i.e., MCNs and IPMNs), this column is included in the table for the purpose of completeness. ** Complete response is defined as the radiographic absence of residual lesion on post-procedural imaging. Incomplete response is defined as either persistent or enlarged residual lesion on post-procedural imaging. If the study authors noted reduction in lesion size without resolution on post-procedural imaging, this is considered a partial response; if this was not recorded by the study authors, these lesions are categorized as incomplete response. *** Of the 17 patients initially treated with a session of saline lavage, 14 received a second follow-up session with ethanol lavage. **** All three patients with complete cyst resolution received initial saline lavage followed by a second session with ethanol lavage.