A prospective study on radiofrequency ablation locally advanced pancreatic cancer.
BACKGROUND
Radiofrequency ablation (RFA) has been suggested as a new treatment option for patients with locally advanced cancer. This study aimed to prospectively evaluate the efficacy and safety of intraoperative RFA in patients with unresectable, locally advanced, non-metastatic carcinoma of the pancreatic head.


METHODS
RFA was the first step of the surgical procedure and was carried out on the mobilized pancreatic head followed by biliary by-pass and gastrojejunal-anastomosis. Intra- and post-operative morbidity and mortality, performance status, pain control, quality of life, and survival at 24 months were evaluated.


RESULTS
Seven patients (3 men and 4 women; median age 66 years, range 47-80 years) were studied and 4 were eligible for treatment. The RFA procedure was carried out in 3 of the 4 patients; in one patient it was not carried out because of the upstaging of the neoplasm. In all 3 patients RFA achieved complete necrosis of the lesion. A biliary fistula developed 7 days after the procedure in one patient; all 3 patients developed ascites 8.6 days (range 7-9 days) on average after RFA. All patients died respectively, at 3, 4, and 5 months after the treatment.


CONCLUSIONS
In our experience, RFA is a feasible procedure, but it presents a very high rate of postoperative complications. Moreover, pain control, life quality and survival rate are poor. The few data suggest no impact on survival.
Casadei
Riccardo
R
Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Ricci
Claudio
C
Pezzilli
Raffaele
R
Serra
Carla
C
Calculli
Lucia
L
Morselli-Labate
Antonio Maria
AM
Santini
Donatella
D
Minni
Francesco
F
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology; D001658:Biliary Fistula / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007582:Jejunostomy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010149:Postoperative Pain / Q000209:etiology; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome