Results of 100 pancreatic radiofrequency ablations in the context of a multimodal strategy for stage III ductal adenocarcinoma.

ABSTRACT

BACKGROUND: Stage III pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with the results of chemoradiation being disappointing. Radiofrequency is an ablation technique employed in many unresectable solid tumours, but its application to pancreatic cancer is limited. We report our experience of radiofrequency ablation (RFA) with cytoreductive intent in stage III PDAC. PATIENTS AND METHODS: One hundred consecutive patients affected by stage III PDAC received RFA combined with chemoradiotherapy. Follow-up was planned on a 3-month basis including clinical evaluation, serum markers and computed tomography scan or MRI. Short-term outcomes and survival data were evaluated. RESULTS: Forty-eight patients received upfront RFA, and 52 had associated palliative surgery. Abdominal complications occurred in 24 patients, and in 15 cases, they were related to RFA. The mortality rate was 3 %. At a median follow-up of 12 months, 55 patients had died of disease and four patients due to unknown causes. Nineteen patients are alive with disease progression, and 22 are alive and progression free. CONCLUSIONS: We presented the broadest experience of RFA in stage III PDAC, focusing on the rationale of its application and considering the advanced stage of disease and the cytoreductive purpose of the procedure. The critical aspects of the technique, along with the unexpected results in efficacy, were discussed.