Intraoperative Ultrasound guided Palliative Radiofrequency Ablation of Unresectable Nonmetastatic Pancreatic Malignancies: A Pilot Observational Study

J Gastrointestin Liver Dis. 2024 Jul 13;33(3):372-378. doi: 10.15403/jgld-5712.

Abstract

Background and aims: Radiofrequency ablation of unresectable pancreatic tumors represents a palliative method in selected patients. The lack of standardization of the technique used as well as the non-homogeneous immediate and long-term results from the reports in the literature made us evaluate in a pilot study the application of a standardized technique through a surgical approach, with the evaluation of the immediate and long-term results.

Methods: Ten consecutive patients diagnosed with unresectable nonmetastatic pancreatic adenocarcinoma were referred for radio-frequency ablation by surgical approach. For that, a UniBlate (AngioDinamics®) internal cooled electrode was used, under intraoperative ultrasound guidance. We analysed the morbidity, mortality and survival associated with this procedure. The median follow-up period was 12 months.

Results: Intraoperative ultrasound was essential for guiding the procedure. No mortality and no major postoperative complications after intraoperative tumoral ablations were noted. The median survival after the procedure was 7.5 months.

Conclusions: Radiofrequency intraoperative ablation of unresectable pancreatic tumors is a feasible procedure, with low morbidity and mortality if standardized, being noninferior to palliative chemotherapy alone in regards with survival. A larger study is necessary to demonstrate the potential benefits in survival, the role of multidisciplinary selection being also mandatory.

Publication types

  • Observational Study

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Palliative Care* / methods
  • Pancreatic Neoplasms* / diagnostic imaging
  • Pancreatic Neoplasms* / mortality
  • Pancreatic Neoplasms* / pathology
  • Pancreatic Neoplasms* / surgery
  • Pilot Projects
  • Radiofrequency Ablation* / adverse effects
  • Radiofrequency Ablation* / methods
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Interventional* / methods