Triple approach strategy for patients with locally advanced pancreatic carcinoma

Giardino, Alessandro; Girelli, R.; Frigerio, Isabella; Regi, Paolo; Cantore, Maurizio; Amato, Alessandra; Lusenti, Annita; Salvia, Roberto; Bassi, Claudio; Pederzoli, Paolo

doi:10.1111/hpb.12027

Cited by 45 publications

(48 citation statements)

References 27 publications

(31 reference statements)

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“…This Italian triple approach strategy led by Roberto Girelli and Claudio Bassi [15] involves lesser interventional trauma and appears to be a better patient option for locally advanced PDAC with elevated SIR, should further studies of radical resection be in agreement with those quoted here [11e14].…”

Section: Sir In Pancreatic Cancersupporting

confidence: 76%

Host systemic inflammatory response influences outcome in pancreatic cancer

Imrie

2015

Pancreatology

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Section: Sir In Pancreatic Cancersupporting

confidence: 76%

Host systemic inflammatory response influences outcome in pancreatic cancer

Imrie

2015

Pancreatology

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“…Moreover, the majority of these tumors are unresectable at the time of diagnosis, with a high percentage of locally advanced disease. While protocols including chemotherapy and chemoradiotherapy frequently lead to disappointing results, the use of ablative techniques, such as radiofrequency ablation, on pancreatic neoplasms seem to provide encouraging results even if they are associated with serious heat-related complications, as reported by Frigerio et al [29,30,31] . The present study was designed to evaluate the safety and feasibility of IRE in ten patients with cytohystological diagnosis of LAPC.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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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.

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“…Also, Giardino et al suggested the so called "triple approach strategy" where RFA is also combined with systemic chemo-radiotherapy and intra-arterial chemotherapy, with even better results and overall survival reaching 34 months [36].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Ablation of Pancreatic Ductal Adenocarcinoma: An Evolving Comrade?

Hadjicostas¹,

Christou²,

Christodoulou³

2016

JCT

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Background: Pancreatic ductal adenocarcinoma (PDAC) presents a challenge for the surgeon due to its aggressiveness and to the stagnation of the management options in cases where complete resection is not feasible. Radiofrequency ablation (RFA) in PDAC is described by a few studies as a promising technique. Methods: We present our 12 years' experience in locally advanced unresectable PDAC with a series of 19 patients. The mean age was 66.8 years. The mean tumour diameter was 8.1 cm. In all patients, RFA was performed during laparotomy using Cooltip©, in some with IOUS monitoring, followed by palliative bypass procedures. Results: The postoperative period was relatively uneventful. A repeat CT showed remarkable changes in the size and morphology of the tumour. We observed significant improvement in pain relief. The mean survival with the RFA was 19.3 months (6 -30 months). Conclusions: Our series suggest that RFA for locally advanced and unresectable PDAC in carefully selected patients (excluding multifocal disease) presents a promising, effective and safe associate for the surgeon. RFA plays a complimentary role to current standard palliative therapy, which may prolong survival and improve quality of life. Whether the laparoscopic approach or other non-invasive methods are feasible, will be a challenge for the following years.

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Triple approach strategy for patients with locally advanced pancreatic carcinoma

Abstract: The multimodal approach seems to be feasible and associated with an improved longer survival rate.

Cited by 45 publications

References 27 publications

Host systemic inflammatory response influences outcome in pancreatic cancer

Host systemic inflammatory response influences outcome in pancreatic cancer

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

Radiofrequency Ablation of Pancreatic Ductal Adenocarcinoma: An Evolving Comrade?

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