Computed Tomography-Guided Cryoablation of Local Recurrence after Primary Resection of Pancreatic Adenocarcinoma

Pusceddu, Claudio; Melis, Luca; Sotgia, Barbara; Fancellu, Alessandro; Meloni, Giovanni Battista

doi:10.4081/cp.2015.741

Cited by 10 publications

(5 citation statements)

References 13 publications

(25 reference statements)

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“…Pancreatic head adenocarcinoma (PHAC) accounts for 80–90% of tumors of the exocrine pancreas and remains associated with a dismal long-term prognosis [ 1 , 2 , 3 ]. Pancreaticoduodenectomy (PD) with adjuvant chemotherapy offers potential cure for patients with PHAC, although even when surgical resection is considered curative, the five-year survival rate barely reaches 25% [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact on Survival and Morbidity of Portal–Mesenteric Resection During Pancreaticoduodenectomy for Pancreatic Head Adenocarcinoma: A Systematic Review and Meta-Analysis of Comparative Studies

Fancellu

Petrucciani

Porcu

et al. 2020

Cancers

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Background: The literature is conflicting regarding oncological outcome and morbidity associated to portal–mesenteric resection during pancreaticoduodenectomy (PD) in patients with pancreatic head adenocarcinoma (PHAC). Methods: A meta-analysis of studies comparing PD plus venous resection (PD+VR) and standard PD exclusively in patients with adenocarcinoma of the pancreatic head was conducted. Results: Twenty-three cohort studies were identified, which included 6037 patients, of which 28.6% underwent PD+VR and 71.4% underwent standard PD. Patients who received PD+VR had lower 1-year overall survival (OS) (odds radio OR 0.79, 95% CI 0.67–0.92, p = 0.003), 3-year OS (OR 0.72, 95% CI 0.59–0.87, p = 0.0006), and 5-year OS (OR 0.57, 95% CI 0.39–0.83, p = 0.003). Patients in the PD+VR group were more likely to have a larger tumor size (MD 3.87, 95% CI 1.75 to 5.99, p = 0.0003), positive lymph nodes (OR 1.24, 95% CI 1.06–1.45, p = 0.007), and R1 resection (OR 1.74, 95% CI 1.37–2.20, p < 0.0001). Thirty-day mortality was higher in the PD+VR group (OR 1.93, 95% CI 1.28–2.91, p = 0.002), while no differences between groups were observed in rates of total complications (OR 1.07, 95% CI, 0.81–1.41, p = 0.65). Conclusions: Although PD+VR has significantly increased the resection rate in patients with PHAC, it has inferior survival outcomes and higher 30-day mortality when compared with standard PD, whereas postoperative morbidity rates are similar. Further research is needed to evaluate the role of PD+VR in the context of multimodality treatment of PHAC.

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Section: Introductionmentioning

confidence: 99%

The Impact on Survival and Morbidity of Portal–Mesenteric Resection During Pancreaticoduodenectomy for Pancreatic Head Adenocarcinoma: A Systematic Review and Meta-Analysis of Comparative Studies

Fancellu

Petrucciani

Porcu

et al. 2020

Cancers

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“…Cross-sections are reconstructed by calculating attenuation coefficients, or how easily the x-ray beams penetrate the volume of the object studied. Unlike ultrasound, CT offers a much better image with higher sensitivity, specificity, and accuracy, and it can be directed precisely at a target area, including but not limited to prostate cancer, pancreatic adenocarcinoma, and renal tumors 127 , 136 , 142 , 143 . However, ultrasound sees benefit from lower price, no radiation exposure, and real-time feedback.…”

Section: Image-guided Cryoablation Cancer Therapymentioning

confidence: 99%

Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation

Kwak¹,

B²,

Lewandowski³

et al. 2022

Theranostics

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With rapid advances in modern imaging, minimally invasive ablative procedures have emerged as popular alternatives to surgical removal of tumors. Tumor ablation modalities currently offered in clinical practice include microwave ablation, radiofrequency ablation, cryoablation, high-intensity focused ultrasound, and irreversible electroporation. Cryoablation, a non-heat-based method of ablation, is increasingly being used for treating various solid tumors. Accumulated comparative data of cryoablation versus heat-based ablation techniques (e.g., radiofrequency and microwave ablation) shows superior tumor response and quicker recovery time. Evolving research has demonstrated that nanocarriers may serves as excellent catalysts for the cryoablation therapy, imaging guidance, and the co-delivery of therapeutics for minimally invasive, precise, and complete treatment of cancer with immune modulation. This review article focuses on the current status of cryoablation in clinical practice, considers opportunities for enhancing therapeutic outcomes from cryoablation, and discusses new research in the field, including theranostic nanoparticles-mediated cryotherapy and combinational cryo-based immunotherapies.

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“…Among them, radiofrequency ablation has been the most commonly used for the treatment of HCC. However, microwave ablation has also been gaining importance in this context[ 38 , 56 , 57 ]. With the refinements of techniques and achievement of satisfying oncologic outcomes, indications for ablative methods have expanded so that they can be used with curative intent in selected patients with HCC, such as those with very early (BCLC-0) or early (BCLC-A) HCC who are not candidates for liver resection or transplantation.…”

Section: Increasing Role Of Percutaneous Ablative Treatmentsmentioning

confidence: 99%

Surgical treatment of hepatocellular carcinoma in the era of COVID-19 pandemic: A comprehensive review of current recommendations

Fancellu

Sanna

Scognamillo

et al. 2021

WJCC

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The new coronavirus disease 2019 (COVID-19) pandemic has resulted in a global health emergency that has also caused profound changes in the treatment of cancer. The management of hepatocellular carcinoma (HCC) across the world has been modified according to the scarcity of care resources that have been diverted mostly to face the surge of hospitalized COVID-19 patients. Oncological and hepatobiliary societies have drafted recommendations regarding the adaptation of guidelines for the management of HCC to the current healthcare situation. This review focuses on specific recommendations for the surgical treatment of HCC ( i.e. , hepatic resection and liver transplantation), which still represents the best chance of cure for patients with very early and early HCC. While surgery should be pursued for very selected patients in institutions where standards of care are maintained, alternative or bridging methods, mostly thermoablation and transarterial therapies, can be used until surgery can be performed. The prognosis of patients with HCC largely depends on both the characteristics of the tumour and the stage of underlying liver disease. Risk stratification plays a pivotal role in determining the most appropriate treatment for each case and needs to balance the chance of cure and the risk of COVID-19 infection during hospitalization. Current recommendations have been critically reviewed to provide a reference for best practices in the clinical setting, with adaptation based on pandemic trends and categorization according to COVID-19 prevalence.

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Computed Tomography-Guided Cryoablation of Local Recurrence after Primary Resection of Pancreatic Adenocarcinoma

Cited by 10 publications

References 13 publications

The Impact on Survival and Morbidity of Portal–Mesenteric Resection During Pancreaticoduodenectomy for Pancreatic Head Adenocarcinoma: A Systematic Review and Meta-Analysis of Comparative Studies

The Impact on Survival and Morbidity of Portal–Mesenteric Resection During Pancreaticoduodenectomy for Pancreatic Head Adenocarcinoma: A Systematic Review and Meta-Analysis of Comparative Studies

Recent progress in cryoablation cancer therapy and nanoparticles mediated cryoablation

Surgical treatment of hepatocellular carcinoma in the era of COVID-19 pandemic: A comprehensive review of current recommendations

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