Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer
Background: Ablative techniques provide in patients with locally advanced pancreatic cancer (LAPC) symptomatic relief, survival benefit and potential downsizing. Irreversible Electroporation (IRE) represents potentially an ideal solution as no thermal tissue damage occurs. The purpose of this review...
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doaj-5520c7edae4d4bd1916d03dc2115c6b22020-11-25T00:55:40ZengMDPI AGCancers2072-66942019-11-011111171810.3390/cancers11111718cancers11111718Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic CancerStefano Lafranceschina0Oronzo Brunetti1Antonella Delvecchio2Maria Conticchio3Michele Ammendola4Giuseppe Currò5Tullio Piardi6Nicola de’Angelis7Nicola Silvestris8Riccardo Memeo9Department of Emergency and Organ Transplantation, University “Aldo Moro” of Bary, 70124 Bary, ItalyMedical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II 2”, 70124 Bari, ItalyDepartment of Emergency and Organ Transplantation, University “Aldo Moro” of Bary, 70124 Bary, ItalyDepartment of Emergency and Organ Transplantation, University “Aldo Moro” of Bary, 70124 Bary, ItalyDepartment of Health Science, General Surgery, Magna Graecia University, Medicine School of Germaneto, 88100 Catanzaro, ItalyDepartment of Health Science, General Surgery, Magna Graecia University, Medicine School of Germaneto, 88100 Catanzaro, ItalyDepartment of Surgery, Hôpital Robert Debré, University of Champagne-Ardenne, 51100 Reims, FranceDepartment of Digestive and Hepato-Pancreato-Biliary Surgery, Henri Mondor University Hospital, AP-HP, Université Paris-Est Créteil (UPEC), 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, FranceMedical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II 2”, 70124 Bari, ItalyDepartment of Emergency and Organ Transplantation, University “Aldo Moro” of Bary, 70124 Bary, ItalyBackground: Ablative techniques provide in patients with locally advanced pancreatic cancer (LAPC) symptomatic relief, survival benefit and potential downsizing. Irreversible Electroporation (IRE) represents potentially an ideal solution as no thermal tissue damage occurs. The purpose of this review is to present an overview on safety, feasibility, oncological results, survival and quality of life improvement obtained by IRE. Methods: A systematic search was performed in PubMed, regarding the use of IRE on PC in humans for studies published in English up to March 2019. Results: 15 original studies embodying 691 patients with unresectable LAPC who underwent IRE were included. As emerged, IRE works better on tumour sizes between 3−4 cm. Oncological results are promising: median OS from diagnosis or treatment up to 27 months. Two groups investigated borderline resectable tumours treated with IRE before resection with margin attenuation, whereas IRE has proved to be effective in pain control. Conclusions: Electroporation is bringing new hopes in LAPC management. The first aim of IRE is to offer a palliative treatment. Further efforts are needed for patient selection, as well as the use of IRE for ‘margin accentuation’ during surgical resection. Even if promising, IRE needs to be validated in large, randomized, prospective series.https://www.mdpi.com/2072-6694/11/11/1718pancreaslocally advancedpancreatic cancerirreversible electroporation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stefano Lafranceschina Oronzo Brunetti Antonella Delvecchio Maria Conticchio Michele Ammendola Giuseppe Currò Tullio Piardi Nicola de’Angelis Nicola Silvestris Riccardo Memeo |
spellingShingle |
Stefano Lafranceschina Oronzo Brunetti Antonella Delvecchio Maria Conticchio Michele Ammendola Giuseppe Currò Tullio Piardi Nicola de’Angelis Nicola Silvestris Riccardo Memeo Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer Cancers pancreas locally advanced pancreatic cancer irreversible electroporation |
author_facet |
Stefano Lafranceschina Oronzo Brunetti Antonella Delvecchio Maria Conticchio Michele Ammendola Giuseppe Currò Tullio Piardi Nicola de’Angelis Nicola Silvestris Riccardo Memeo |
author_sort |
Stefano Lafranceschina |
title |
Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer |
title_short |
Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer |
title_full |
Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer |
title_fullStr |
Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer |
title_full_unstemmed |
Systematic Review of Irreversible Electroporation Role in Management of Locally Advanced Pancreatic Cancer |
title_sort |
systematic review of irreversible electroporation role in management of locally advanced pancreatic cancer |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2019-11-01 |
description |
Background: Ablative techniques provide in patients with locally advanced pancreatic cancer (LAPC) symptomatic relief, survival benefit and potential downsizing. Irreversible Electroporation (IRE) represents potentially an ideal solution as no thermal tissue damage occurs. The purpose of this review is to present an overview on safety, feasibility, oncological results, survival and quality of life improvement obtained by IRE. Methods: A systematic search was performed in PubMed, regarding the use of IRE on PC in humans for studies published in English up to March 2019. Results: 15 original studies embodying 691 patients with unresectable LAPC who underwent IRE were included. As emerged, IRE works better on tumour sizes between 3−4 cm. Oncological results are promising: median OS from diagnosis or treatment up to 27 months. Two groups investigated borderline resectable tumours treated with IRE before resection with margin attenuation, whereas IRE has proved to be effective in pain control. Conclusions: Electroporation is bringing new hopes in LAPC management. The first aim of IRE is to offer a palliative treatment. Further efforts are needed for patient selection, as well as the use of IRE for ‘margin accentuation’ during surgical resection. Even if promising, IRE needs to be validated in large, randomized, prospective series. |
topic |
pancreas locally advanced pancreatic cancer irreversible electroporation |
url |
https://www.mdpi.com/2072-6694/11/11/1718 |
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