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The role of irreversible electroporation (IRE) for locally advanced pancreatic cancer : a systematic review of safety and efficacy

Ansari, Daniel LU ; Kristoffersson, Stina; Andersson, Roland LU and Bergenfeldt, Magnus LU (2017) In Scandinavian Journal of Gastroenterology 52(11). p.1165-1171
Abstract

Objectives: Irreversible electroporation (IRE) is a new modality for tumor ablation. Electrodes are placed around the tumor, and a pulsed, direct current with a field strength of 2000 V/cm is delivered. The direct current drives cells into apoptosis and cell death without causing significant heating of the tissues, which spares the extracellular matrix and proteins. The purpose of this review was to evaluate current experience of IRE for the ablation of pancreatic cancer. Material and methods: We searched PubMed for all studies of IRE in human pancreatic cancer in English reporting at least 10 patients. Results: The search yielded 10 studies, comprising a total of 446 patients. Percutaneous IRE was done in 142 patients, while 304... (More)

Objectives: Irreversible electroporation (IRE) is a new modality for tumor ablation. Electrodes are placed around the tumor, and a pulsed, direct current with a field strength of 2000 V/cm is delivered. The direct current drives cells into apoptosis and cell death without causing significant heating of the tissues, which spares the extracellular matrix and proteins. The purpose of this review was to evaluate current experience of IRE for the ablation of pancreatic cancer. Material and methods: We searched PubMed for all studies of IRE in human pancreatic cancer in English reporting at least 10 patients. Results: The search yielded 10 studies, comprising a total of 446 patients. Percutaneous IRE was done in 142 patients, while 304 patients were treated during laparotomy. Tumor sizes ranged from median 2.8 to 4.5 cm. Post-procedural complications occurred in 35% of patients, most of them were less severe. Nine patients (2.0%) died after the procedure. The technical success rate was 85–100%. The median recurrence-free survival was 2.7–12.4 months after IRE treatment. The median overall survival was 7–23 months postoperatively. The longest overall survival was noted when IRE was used in conjunction with pancreatic resection. Conclusions: IRE seems feasible and safe with a low post-procedural mortality. Further efforts are needed to address patient selection and efficacy of IRE, as well as the use of IRE for ‘margin accentuation’ during surgical resection.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
electroporation, irreversible, pancreas, tumor ablation
in
Scandinavian Journal of Gastroenterology
volume
52
issue
11
pages
1165 - 1171
publisher
Taylor & Francis
external identifiers
  • scopus:85029678169
ISSN
0036-5521
DOI
10.1080/00365521.2017.1346705
language
English
LU publication?
yes
id
fc4509f0-5219-4a33-ac20-0f41a09ea86e
date added to LUP
2017-10-06 10:11:58
date last changed
2018-01-07 12:20:55
@article{fc4509f0-5219-4a33-ac20-0f41a09ea86e,
  abstract     = {<p>Objectives: Irreversible electroporation (IRE) is a new modality for tumor ablation. Electrodes are placed around the tumor, and a pulsed, direct current with a field strength of 2000 V/cm is delivered. The direct current drives cells into apoptosis and cell death without causing significant heating of the tissues, which spares the extracellular matrix and proteins. The purpose of this review was to evaluate current experience of IRE for the ablation of pancreatic cancer. Material and methods: We searched PubMed for all studies of IRE in human pancreatic cancer in English reporting at least 10 patients. Results: The search yielded 10 studies, comprising a total of 446 patients. Percutaneous IRE was done in 142 patients, while 304 patients were treated during laparotomy. Tumor sizes ranged from median 2.8 to 4.5 cm. Post-procedural complications occurred in 35% of patients, most of them were less severe. Nine patients (2.0%) died after the procedure. The technical success rate was 85–100%. The median recurrence-free survival was 2.7–12.4 months after IRE treatment. The median overall survival was 7–23 months postoperatively. The longest overall survival was noted when IRE was used in conjunction with pancreatic resection. Conclusions: IRE seems feasible and safe with a low post-procedural mortality. Further efforts are needed to address patient selection and efficacy of IRE, as well as the use of IRE for ‘margin accentuation’ during surgical resection.</p>},
  author       = {Ansari, Daniel and Kristoffersson, Stina and Andersson, Roland and Bergenfeldt, Magnus},
  issn         = {0036-5521},
  keyword      = {electroporation,irreversible,pancreas,tumor ablation},
  language     = {eng},
  month        = {11},
  number       = {11},
  pages        = {1165--1171},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {The role of irreversible electroporation (IRE) for locally advanced pancreatic cancer : a systematic review of safety and efficacy},
  url          = {http://dx.doi.org/10.1080/00365521.2017.1346705},
  volume       = {52},
  year         = {2017},
}