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Percutaneous ablation therapies of inoperable pancreatic cancer: a systematic review.

Ierardi AM, Lucchina N, Bacuzzi A, Marco de C, Bracchi E, Cocozza E, Dionigi G, Tsetis D, Floridi C, Carrafiello G - Ann Gastroenterol (2015 Oct-Dec)

Bottom Line: Initial studies about ablation therapies of the pancreas were associated with significant morbidity and mortality, which limited widespread adoption.Development of techniques with high quality imaging used as guidance improve outcomes reducing complications.They are performed by very skilled operators in highly specialized centers.

View Article: PubMed Central - PubMed

Affiliation: Interventional Radiology Unit, Department of Radiology (Anna Maria Ierardi, Natalie Lucchina, De Chiara Marco, Elena Bracchi, Gianpaolo Carrafiello), University of Insubria, Varese, Italy.

ABSTRACT
Initial studies about ablation therapies of the pancreas were associated with significant morbidity and mortality, which limited widespread adoption. Development of techniques with high quality imaging used as guidance improve outcomes reducing complications. Moreover, only few experiences of percutaneous pancreatic ablations are reported. They are performed by very skilled operators in highly specialized centers. This review presents the current status of percutaneous local ablative therapies in the treatment of advanced pancreatic cancer.

No MeSH data available.


Related in: MedlinePlus

(A) Contrast-enhanced computed tomography reveals the presence of the pancreatic tumor. (B) Antenna for microwave ablation within the lesion, positioned under ultrasound guidance
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Figure 1: (A) Contrast-enhanced computed tomography reveals the presence of the pancreatic tumor. (B) Antenna for microwave ablation within the lesion, positioned under ultrasound guidance

Mentions: Although there are no pre-clinical studies published about MWA of pancreatic lesions and only two articles about the use of MWA in pancreatic cancer are available, this technique is considered an emerging option for the treatment of a variety of tumors and, when compared with RFA, offers several advantages. The largest case series of MWA in locally advanced pancreatic cancer reported in the literature includes 15 patients, but the ablation was performed intraoperatively at the time of palliative bypass surgery [21]. Carrafiello et al [17] (Table 2) evaluated the safety and efficacy of percutaneous MWA treatment in locally advanced, non resectable, non metastatic pancreatic head cancer [17]. Ten patients were treated, with percutaneous (n=5) or laparotomic (n=5) approach. In all patients treated with the percutaneous approach, MWA was performed under moderate sedation. The path of the antenna was carefully evaluated on the basis of a preliminary US examination; a path was chosen such that the vessels, stomach, and bowel were far from the antenna (Fig. 1 A, B). The most important evaluation involved the prediction of the ablation area on the basis of the position of the antenna; in some cases, cone-beam CT acquisition provided a correct and safe position for the antenna with respect to the adjacent structures [17].


Percutaneous ablation therapies of inoperable pancreatic cancer: a systematic review.

Ierardi AM, Lucchina N, Bacuzzi A, Marco de C, Bracchi E, Cocozza E, Dionigi G, Tsetis D, Floridi C, Carrafiello G - Ann Gastroenterol (2015 Oct-Dec)

(A) Contrast-enhanced computed tomography reveals the presence of the pancreatic tumor. (B) Antenna for microwave ablation within the lesion, positioned under ultrasound guidance
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4585388&req=5

Figure 1: (A) Contrast-enhanced computed tomography reveals the presence of the pancreatic tumor. (B) Antenna for microwave ablation within the lesion, positioned under ultrasound guidance
Mentions: Although there are no pre-clinical studies published about MWA of pancreatic lesions and only two articles about the use of MWA in pancreatic cancer are available, this technique is considered an emerging option for the treatment of a variety of tumors and, when compared with RFA, offers several advantages. The largest case series of MWA in locally advanced pancreatic cancer reported in the literature includes 15 patients, but the ablation was performed intraoperatively at the time of palliative bypass surgery [21]. Carrafiello et al [17] (Table 2) evaluated the safety and efficacy of percutaneous MWA treatment in locally advanced, non resectable, non metastatic pancreatic head cancer [17]. Ten patients were treated, with percutaneous (n=5) or laparotomic (n=5) approach. In all patients treated with the percutaneous approach, MWA was performed under moderate sedation. The path of the antenna was carefully evaluated on the basis of a preliminary US examination; a path was chosen such that the vessels, stomach, and bowel were far from the antenna (Fig. 1 A, B). The most important evaluation involved the prediction of the ablation area on the basis of the position of the antenna; in some cases, cone-beam CT acquisition provided a correct and safe position for the antenna with respect to the adjacent structures [17].

Bottom Line: Initial studies about ablation therapies of the pancreas were associated with significant morbidity and mortality, which limited widespread adoption.Development of techniques with high quality imaging used as guidance improve outcomes reducing complications.They are performed by very skilled operators in highly specialized centers.

View Article: PubMed Central - PubMed

Affiliation: Interventional Radiology Unit, Department of Radiology (Anna Maria Ierardi, Natalie Lucchina, De Chiara Marco, Elena Bracchi, Gianpaolo Carrafiello), University of Insubria, Varese, Italy.

ABSTRACT
Initial studies about ablation therapies of the pancreas were associated with significant morbidity and mortality, which limited widespread adoption. Development of techniques with high quality imaging used as guidance improve outcomes reducing complications. Moreover, only few experiences of percutaneous pancreatic ablations are reported. They are performed by very skilled operators in highly specialized centers. This review presents the current status of percutaneous local ablative therapies in the treatment of advanced pancreatic cancer.

No MeSH data available.


Related in: MedlinePlus