Minimally invasive percutaneous irreversible electroporation (IRE) may help make surgery an option for unresectable, locally advanced pancreatic cancer patients, according to a new study.

Researchers at the University of Miami (FL, USA) reviewed the records of eight patients (aged 51-72 years) with locally advanced pancreatic adenocarcinomas (LAPCs) who were referred for IRE that was performed between December 2010 and September 2011; all the patients had prior chemotherapy, and seven had prior radiation. The procedures were done percutaneously under general anesthesia (GA) using a standard protocol in all patients. The primary endpoint was safety, and the secondary endpoints included survival and resection rate after procedure.

The results showed that out of the original eight inoperable individuals, two went on to have surgery. Both had successful resections and remained disease-free at two and six months after resection, respectively. Among the six remaining patients, two were lost to follow-up and one had progressive disease after three months. One patient had a negative follow-up positron emission tomography (PET) scan and surgery was planned; the two remaining patients were under follow-up to determine resectability. The study was presented at the Society of Interventional Radiology (SIR) 37th annual scientific meeting, held during March 2012 in San Francisco (CA, USA).

“Without IRE, these people are essentially left with chemotherapy and radiation therapy. At this point the prognosis for this group is pretty dismal and they have an estimated survival of less than one year,” said lead author and study presenter Govindarajan Narayanan, MD, of the division of vascular/interventional radiology, and colleagues. “With this procedure, there is the potential to have the tumor peeled off the blood vessels, and follow up treatment to repair the affected area of the pancreas.”

IRE uses microsecond electrical pulses to force open and destroy tumor cells around a vast and delicate network of blood vessels. The technique has been successful in treating primary and metastatic liver cancer, and IRE is now in the first stages of implementation as a treatment for pancreatic cancer. The procedure is performed using the NanoKnife Tissue Ablation system, a product of AngioDynamics (Latham, NY, USA).

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