Irreversible electroporation of the pancreas: Definitive local therapy without systemic effects

Bower, Matthew; Sherwood, Leslie C.; Li, Yan; Martin, Robert C.G.

doi:10.1002/jso.21899

Cited by 171 publications

(98 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is underlined by the fact that there was no significant change in serum amylase levels in our patients in the first and second postoperative week compared to the preoperative levels. This observation is consistent with findings by bower et al who showed that the serum levels of pancreatic enzymes show only a transient mild increase early in the first postoperative week [11,12]. even though there was no laboratory evidence of acute pancreatitis after ire, postoperative ct showed signs of various degrees of peripancreatic inflammation in the majority of patients.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Treatment of locally advanced pancreatic cancer by percutaneous and intraoperative irreversible electroporation: general hospital cancer center experience

Lambert¹,

Horejs²,

Krška³

et al. 2016

neo

View full text Add to dashboard Cite

The aim of this study was to evaluate the safety of irreversible electroporation (ire) and the outcome of patients undergoing ire of locally advanced pancreatic cancer (Pc). twenty-one patients with unresectable Pc underwent open (n=19) or percutaneous (n=2) ire of the tumor using the Nanoknife system with two electrodes that were repositioned several times to affect the whole mass. The size of the tumor was 39±10mm with a range from 21 to 65mm. Five patients underwent neoadjuvant chemotherapy and seven patients were treated with chemotherapy after ire. complications occurred in five patients, which resulted in prolongation of the average hospital stay from 10 to 34 days. There was no mortality in the first postoperative month. median survival after ire was 10.2 months compared to 9.3 months in a matched cohort (hazard ratio = .54, p = .053). The quality of life was declining slowly. 81% of time after ire the Karnofsky performance status was ≥70 and sharp decline occurred approximately 8 weeks before death.in conclusion, ire is a safe palliative treatment option for a percentage of patients with locally advanced pancreatic carcinoma. The patients treated with open ire lived a decent life until 8 weeks before their death. We believe that ire of pancreatic carcinoma can be regarded as an option, if imaging or explorative laparotomy show that r0 resection in not possible.

show abstract

Section: Discussionsupporting

confidence: 92%

“…unlike thermal ablation techniques, ire poses a minimal risk of damaging adjacent vascular structures or inducing pancreatitis [11]. This is underlined by the fact that there was no significant change in serum amylase levels in our patients in the first and second postoperative week compared to the preoperative levels.…”

Section: Discussionmentioning

confidence: 53%

Treatment of locally advanced pancreatic cancer by percutaneous and intraoperative irreversible electroporation: general hospital cancer center experience

Lambert¹,

Horejs²,

Krška³

et al. 2016

neo

View full text Add to dashboard Cite

show abstract

“…It has been clearly demonstrated that the effectiveness of LEDC is highly associated with the distribution of the electric field in the tissue (with the contributing variables including voltage, distance between the electrodes and depth of electrodes insertion) required to reach the optimal electrode configuration and tumor coverage [3,10,36,38,39,40,41]. Irreversible electroporation aims to completely extirpate the tumor or, at least, to dramatically modify the neoplastic microenvironment without damaging the surrounding tissues or vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, this process leads to the creation of nanopores with a disruption of the lipid bilayer and cell death, due to apoptosis, preserving the underlying extracellular matrix [5,6,7,8,9,10,11]. Consequently, IRE has begun to emerge as an important ablation technique, that unlike radiofrequency [12] and microwave or laser [13] does not require the application of thermal energy, thereby preserving sensitive structures located near the tumor, such as nerves, bile ducts, vessels, and the gastrointestinal tract [14,15,16].…”

Section: Introductionmentioning

confidence: 99%

Safety and Feasibility of Irreversible Electroporation (IRE) in Patients with Locally Advanced Pancreatic Cancer: Results of a Prospective Study

et al. 2015

View full text Add to dashboard Cite

Purpose: To evaluate the safety of the NanoKnife Low Energy Direct Current (LEDC) System (Irreversible Electroporation, IRE) in order to treat patients with unresectable pancreatic adenocarcinoma. Methods: Prospective, nonrandomized, single-center clinical evaluation of ten patients with a cytohystological diagnosis of unresectable locally advanced pancreatic cancer (LAPC) that was no further responsive to standard treatments. The primary outcome was the rate of procedure-related abdominal complications. The secondary endpoints included the evaluation of the short-term efficacy of IRE through the evaluation of tumor reduction at imaging and biological tumor response as shown by CA 19-9, clinical assessments and patient quality of life. Results: Ten patients (5 males, 5 females) were enrolled, with a median age of 66 and median tumor size of 30 mm. All patients were treated successfully with a median procedure time of 79.5 min. Two procedure-related complications were described in one patient (10%): a pancreatic abscess with a pancreoduodenal fistula. Three patients had early progression of disease: one patient developed pulmonary metastases 30 days post-IRE and two patients had liver metastases 60 days after the procedure. We registered an overall survival of 7.5 months (range: 2.9-15.9). Conclusions: IRE is a safe procedure in patients with LAPC and may represent a new technological option in the treatment and multimodality management of this disease.

show abstract

“…Based on initial animal and case report studies [71] [72], a small series of 14 patients with unresectable tumors have been treated by IRE. Two patients ultimately underwent surgery and were disease free at 11 and 14 months.…”

Section: Pancreasmentioning

confidence: 99%

Advances in Interventional Oncology: Percutaneous Therapies

Muallem

Solomon

2014

Curr Radiol Rep

View full text Add to dashboard Cite

The field of interventional oncology has emerged over the last decade to focus on the minimally invasive image-guided techniques for the treatment of cancer. Ablative techniques specifically have evolved in more recent years and garnered significant evidence supporting their increased inclusion in standards of care and their novel use as curative or disease-modifying therapies, while still maintaining a large role in supportive or symptomatic treatment. Percutaneous ablation will more than likely continue to evolve because of the parallel innovations in imaging and engineered medical devices used in percutaneous interventions but also the improved understanding of cancer behavior and development of personalized cancer therapy.

show abstract

Irreversible electroporation of the pancreas: Definitive local therapy without systemic effects

Abstract: This animal model demonstrates that IRE of the pancreas performed at an optimal voltage is well tolerated, with rapid resolution of pancreatic inflammation and preservation of vascular structures.

Cited by 171 publications

References 26 publications

Treatment of locally advanced pancreatic cancer by percutaneous and intraoperative irreversible electroporation: general hospital cancer center experience

Treatment of locally advanced pancreatic cancer by percutaneous and intraoperative irreversible electroporation: general hospital cancer center experience

Safety and Feasibility of Irreversible Electroporation (IRE) in Patients with Locally Advanced Pancreatic Cancer: Results of a Prospective Study

Advances in Interventional Oncology: Percutaneous Therapies

Contact Info

Product

Resources

About