title: Triple approach strategy for patients with locally advanced pancreatic carcinoma.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is a relatively new technique, applied to metastatic solid tumours which, in recent studies, has been shown to be feasible and safe on locally advanced pancreatic carcinoma (LAPC). RFA can be combined with radio-chemotherapy (RCT) and intra-arterial plus systemic chemotherapy (IASC). The aim of this study was to investigate the impact on the prognosis of a multimodal approach to LAPC and define the best timing of RFA.
  
  
  METHODS
  This is a retrospective observational study of patients who have consecutively undergone RFA associated with multiple adjuvant approaches.
  
  
  RESULTS
  Between February 2007 and December 2011, 168 consecutive patients were treated by RFA, of which 107 were eligible for at least 18 months of follow-up. Forty-seven patients (group 1) underwent RFA as an up-front treatment and 60 patients as second treatment (group 2) depending on clinician choice. The median overall survival (OS) of the whole series was 25.6 months: 14.7 months in the group 1 and 25.6 months in the group 2 (P = 0.004). Those patients who received the multimodal treatment (RFA, RCT and IASC-triple approach strategy) had an OS of 34.0 months.
  
  
  CONCLUSIONS
  The multimodal approach seems to be feasible and associated with an improved longer survival rate.
authors: Pancreatic Unit, Casa di Cura Pederzoli, Peschiera del Garda (VR), Italy. giardinoalessandro@gmail.com
authors: Alessandro
authors: A
authors: Giardino
authors: Roberto
authors: R
authors: Girelli
authors: Isabella
authors: I
authors: Frigerio
authors: Paolo
authors: P
authors: Regi
authors: Maurizio
authors: M
authors: Cantore
authors: Auriemma
authors: A
authors: Alessandra
authors: Annita
authors: A
authors: Lusenti
authors: Roberto
authors: R
authors: Salvia
authors: Claudio
authors: C
authors: Bassi
authors: Paolo
authors: P
authors: Pederzoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome