Bronchoscopic pulsed-electric field ablation for carcinoid tumor: robotic-assisted and non-robotic approach

Pulmonary carcinoid tumors represent indolent neuroendocrine neoplasms for which surgery remains the standard of care. Patients ineligible for surgery or radiation have limited treatment options. Endoscopic pulsed-electric field (PEF) ablation via robotic-assisted and non-robotic assisted bronchoscopy platforms is emerging as a minimally invasive alternative for lung malignancies.

A multicenter retrospective study of patients with pulmonary carcinoid lesions treated with bronchoscopic PEF ablation. ssRAB or EBUS were used to navigate to the target lesions and deliver PEF ablation via a 21-gauge needle, tool-in-lesion confirmed by mobile cone beam computed tomography (CT). Procedure details, intra- and post-procedural complications, and follow-up chest CT were assessed for tumor response and safety outcomes.

Ten carcinoid tumors from eight patients were successfully ablated. The mean tumor size reduction was 8.10 mm or an overall percentage reduction of 53.9%, range 25-100%. No major complications occurred. Three patients presented mild intraprocedural bleeding. The median follow-up time was 3.5 months (IQR 3-4.5). One patient underwent re-ablation due to tumor recurrence without complications, and two PPN showed complete resolution at follow-up.

PEF ablation delivered via ssRAB and EBUS for pulmonary carcinoid tumors appeared feasible and safe, with promising short-term radiographic responses. This approach may provide a minimally invasive treatment option for patients who are not candidates for surgery or radiation.