A prospective, multi-institution assessment of irreversible electroporation for treatment of locally advanced pancreatic adenocarcinoma: initial outcomes from the AHPBA pancreatic registry
Journal
HPB
Journal Volume
21
Journal Issue
8
Pages
1024-1031
Date Issued
2019
Author(s)
Abstract
Background: The optimal treatment and management of locally advanced pancreatic cancer (LAPC) remains unclear and controversial. This study aimed to report the initial outcomes of the AHPBA Registry and evaluate the reproducibility of existing evidence that the addition of Irreversible Electroporation (IRE), a nonthermal ablative treatment, confers survival benefits beyond standard therapeutic options for patients with LAPC. Methods: From December 2015 to October 2017, patients with LAPC were treated with open-technique IRE following the AHPBA Registry Protocols. Patient demographics, long-term outcomes, and adverse events were recorded. Survival analyses were performed using Kaplan-Meier (KM) curves for overall survival (OS), progression free survival (PFS) and time to progression (TTP). Results: A total of 152 patients underwent successful IRE. Morbidity and mortality were 18% and 2% respectively, with 19 (13%) patients experiencing severe adverse events. Nine (6%) patients presented with local recurrence. Median TTP, PFS, and OS from diagnosis were 27.3 months, 22.8 months, and 30.7 months respectively. Conclusion: The combination of IRE with established multiagent therapy is safe and demonstrates encouraging survival among patients with LAPC. IRE is associated with a low rate of serious adverse events and has been optimized for more widespread adoption through the standardized protocols available through the AHPBA registry. ? 2019 International Hepato-Pancreato-Biliary Association Inc.
SDGs
Other Subjects
adult; advanced cancer; aged; Article; body mass; cancer mortality; cancer recurrence; cancer registry; cancer survival; clinical assessment; clinical evaluation; clinical outcome; cohort analysis; computer assisted tomography; endocrine disease; follow up; gastrointestinal disease; health care utilization; hematologic disease; human; irreversible electroporation; kidney disease; liver disease; lung disease; major clinical study; mental disease; morbidity; neurologic disease; observational study; overall survival; pancreas adenocarcinoma; pancreas disease; postoperative infection; postoperative period; progression free survival; prospective study; surgical wound; survival analysis; treatment outcome; tumor volume; vascular disease; adenocarcinoma; adjuvant chemotherapy; cancer staging; clinical trial; disease free survival; electroporation; female; Kaplan Meier method; male; middle aged; mortality; multicenter study; multimodality cancer therapy; pancreas tumor; pathology; patient safety; procedures; prognosis; proportional hazards model; register; risk assessment; tumor invasion; tumor recurrence; Adenocarcinoma; Adult; Aged; Chemotherapy, Adjuvant; Cohort Studies; Combined Modality Therapy; Disease-Free Survival; Electroporation; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Pancreatic Neoplasms; Patient Safety; Prognosis; Proportional Hazards Models; Prospective Studies; Registries; Risk Assessment; Survival Analysis; Treatment Outcome
Publisher
Elsevier B.V.
Type
journal article