title: Combination treatment with comprehensive cryoablation and immunotherapy in metastatic pancreatic cancer.
abstract: OBJECTIVE
  The aim of this study was to retrospectively assess the effect of comprehensive cryosurgery (ablation of intrapancreatic and extrapancreatic tumors) plus immunotherapy in metastatic pancreatic cancer.
  
  
  METHODS
  We divided 106 patients (57 men, 49 women; median age, 65 years) into the cryoimmunotherapy (31 patients), cryotherapy (36 patients), immunotherapy (17 patients), and chemotherapy groups (22 patients). Pretreatment immune function was tested in patients who underwent immunotherapy. Overall survival (OS) after diagnosis of metastatic pancreatic cancer was assessed after a 4-year follow-up.
  
  
  RESULTS
  Median OS was higher in the cryoimmunotherapy (13 months) and cryotherapy groups (7 months) than in the chemotherapy group (3.5 months; both P < 0.001) and was higher in the cryoimmunotherapy group than in the cryotherapy (P < 0.05) and immunotherapy groups (5 months; P < 0.001). In both the cryoimmunotherapy and cryotherapy groups, median OS was higher after multiple cryoablations than after a single cryoablation (P = 0.0048 and 0.041, respectively). In both groups, the median OS was higher in patients with normal immunologic function than in those with immune dysfunction (P < 0.0001 and P = 0.0004, respectively).
  
  
  CONCLUSIONS
  Cryoimmunotherapy significantly increased OS in metastatic pancreatic cancer. Multiple cryoablations and normal pretreatment immunologic function were associated with better prognosis.
authors.affiliation: From the *Fuda Cancer Hospital, School of Medicine, Jinan University; †Fuda Institute of Cryosurgery for Cancer; and ‡Fuda Hospital, School of Medicine, Jinan University, Guangzhou, China.
authors.forename: Lizhi
authors.initials: L
authors.lastname: Niu
authors.forename: Jibing
authors.initials: J
authors.lastname: Chen
authors.forename: Lihua
authors.initials: L
authors.lastname: He
authors.forename: Mengtian
authors.initials: M
authors.lastname: Liao
authors.forename: Yuanying
authors.initials: Y
authors.lastname: Yuan
authors.forename: Jianying
authors.initials: J
authors.lastname: Zeng
authors.forename: Jialiang
authors.initials: J
authors.lastname: Li
authors.forename: Jiansheng
authors.initials: J
authors.lastname: Zuo
authors.forename: Kecheng
authors.initials: K
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D003131:Combined Modality Therapy; D003452:Cryosurgery / Q000379:methods*; D055612:Cytokine-Induced Killer Cells / Q000276:immunology; D003713:Dendritic Cells / Q000276:immunology; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D007167:Immunotherapy / Q000379:methods*; D016219:Immunotherapy, Adoptive; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000276:immunology / Q000556:secondary / Q000628:therapy*; D012189:Retrospective Studies