Percutaneous irreversible electroporation with systemic treatment for locally advanced pancreatic adenocarcinoma.

Journal of Gastrointestinal Oncology
Edward LeenHarpreet Wasan

Abstract

The prognosis for unresectable locally advanced pancreatic adenocarcinoma (LAPC) remains poor. There is increasing interest in modern ablative techniques to improve outcomes. We report on the potential value of integrating percutaneous irreversible electroporation (IRE) in patients undergoing systemic chemotherapy. Seventy-five patients with unresectable pancreatic carcinoma underwent percutaneous IRE after chemotherapy using computerised tomography guidance under general anaesthesia. Postoperative immediate and 30-day morbidity and mortality, progression-free (PFS) and overall survival (OS) were evaluated. Post-procedural immediate and 30-day mortality rates were both zero. All-grade adverse events were 25%. Median in-patient stay was 1 day (range, 1-5 days). Median OS and PFS post-IRE for LAPC were 27 and 15 months respectively. Four patients with LAPC down-staged post-IRE ablation to be surgically resectable, with R0 resections in 3 cases. These results suggest that percutaneous IRE ablation of unresectable LAPC is safe to integrate with standard-of-care chemotherapy and may improve survival, which provides a template for further evaluation in prospective randomized clinical trials.

Citations

Jan 24, 2019·European Radiology Experimental·Mirko D'OnofrioRiccardo De Robertis
Mar 26, 2019·Scandinavian Journal of Gastroenterology·Rasmus Virenfeldt FlakOle Thorlacius-Ussing
Jan 1, 2019·World Journal of Gastrointestinal Oncology·Jun-Jun SuYong-Liang Chen
Sep 21, 2019·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Daniele MaiettiniFranco Orsi
Dec 13, 2019·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Yusef MoullaInes Gockel
Aug 31, 2020·Journal of Vascular and Interventional Radiology : JVIR·Eran van VeldhuisenMartijn R Meijerink
Mar 3, 2021·Seminars in Oncology·Wooil KwonMichael D Kluger
May 15, 2021·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Rasmus Virenfeldt FlakOle Thorlacius-Ussing
Jun 3, 2021·Cancers·Govindarajan NarayananMehul H Doshi
May 16, 2021·Journal of Biomechanical Engineering·Zheng FangBing Zhang
May 27, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·R V FlakLars J Petersen

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