REVIEW  CONTROVERSIES IN PANCREATIC SURGERY 

Minerva Chirurgica 2019 June;74(3):263-9

DOI: 10.23736/S0026-4733.18.07881-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Ablation treatments in unresectable pancreatic cancer

Salvatore PAIELLA ¹ ✉, Matteo DE PASTENA ¹, Francesco ROMEO ¹, Mirko D’ONOFRIO ², Martina FONTANA ¹, Antonio PEA ¹, Giulia DE MARCHI ³, Stefano F. CRINÒ ⁴, Claudio BASSI ¹, Roberto SALVIA ¹

¹ Unit of General and Pancreatic Surgery, Pancreas Institute, Policlinico GB Rossi, University of Verona, Verona, Italy; ² Unit of Radiology, Pancreas Institute, Policlinico GB Rossi, University of Verona, Verona, Italy; ³ Unit of Gastroenterology B, Pancreas Institute, Policliclino GB Rossi, University of Verona, Verona, Italy; ⁴ Unit of Gastroenterology and Digestive Endoscopy, Pancreas Institute, Policliclino GB Rossi, University of Verona, Verona, Italy

Ablation treatments have been increasingly applied as an alternative treatment for unresectable locally advanced pancreatic cancer (LAPC). The goal of LAPC therapy is surgical resection with negative margins (R0); however, that can be achieved only in a minority of patients and only following neoadjuvant treatment. Ablation might be useful for those patients with unresectable LAPC that do not progress towards metastatic stage and do not experience a true downstaging. Indeed, some LAPC that tend to grow locally, might be the subgroup of tumors that could benefit from ablation. Experience is necessary to select patients and the technique to adopt, since serious or fatal complications can occur. This review aims to discuss the role of ablation treatments in LAPC, with a unique focus on radiofrequency ablation and irreversible electroporation.

KEY WORDS: Pancreatic neoplasms - Radiofrequency ablation - Electroporation