Open radiofrequency ablation as upfront treatment for locally advanced pancreatic cancer: Requiem from a randomized controlled trial
| Autor: | Emilio Barbi, Alessandro Passardi, Claudio Bassi, Alessandro Giardino, D'Onofrio Mirko, Roberto Girelli, Roberto Bianco, Gianni Boz, Giuseppe Malleo, Michele Milella, Andrea Mambrini, P. Regi, Isabella Frigerio, Elena Viviani, G. Fiorentini, Filippo Scopelliti, Maurizio Cantore, Roberto Salvia, Salvatore Paiella, Nadia Cardarelli, Gabriella Lionetto, Giovanni Butturini |
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| Přispěvatelé: | Frigerio, Isabella, Paiella, Salvatore, Barbi, Emilio, Bianco, Roberto, Boz, Gianni, Butturini, Giovanni, Cantore, Maurizio, Cardarelli, Nadia, Mirko, D'Onofrio, Fiorentini, Gianmaria, Giardino, Alessandro, Lionetto, Gabriella, Malleo, Giuseppe, Mambrini, Andrea, Milella, Michele, Passardi, Alessandro, Regi, Paolo, Salvia, Roberto, Scopelliti, Filippo, Viviani, Elena, Bassi, Claudio, Girelli, Roberto |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
RFA
medicine.medical_specialty Ablative therapy Radiofrequency ablation Endocrinology Diabetes and Metabolism Context (language use) law.invention Advanced PDAC 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Statistical significance Pancreatic cancer medicine Humans Pancrea In patient Pancreas Radiofrequency Ablation Hepatology business.industry Liver Neoplasms Gastroenterology Pancreatic Neoplasm medicine.disease Progression-Free Survival Surgery Locally advanced pancreatic cancer Pancreatic Neoplasms Treatment Outcome Liver Neoplasm 030220 oncology & carcinogenesis Catheter Ablation 030211 gastroenterology & hepatology business Chemoradiotherapy Human |
| Popis: | Background Local ablation of pancreatic cancer has been suggested as an option to manage locally advanced pancreatic cancer (LAPC) although no robust evidence has been published to date to support its application. The aim of this study is to compare overall survival (OS) and progression-free survival (PFS) in patients receiving both radiofrequency ablation (RFA) and conventional chemoradiotherapy (CHRT) with patients receiving CHRT only. Methods This is a multicentre prospective randomized controlled trial (RCT). Patients with LAPC diagnosed by the Pancreas-Ablation-Team-Verona were randomly assigned to open RFA (Group A) or CHRT (Group B). Survival analyses were performed using the Kaplan-Meier method and compared using the log-rank test. Statistical significance was set at p Results One hundred LAPC patients were enrolled from January 2014 to August 2016. 33% of patients in Group A did not receive the designated procedure because of intraoperative findings of liver (18.7%) or peritoneal metastases (43.8%), or technical contraindications (37.5%). We did not observe any statistically significant survival benefit from RFA compared to CHRT, neither in terms of OS (medians of 14.2 months and 18.1 months, respectively, p = 0.639) nor PFS (medians of 8 months and 6 months respectively, p = 0.570). Mortality was nil and RFA-related morbidity was 15.6%. In 13% of subjects, conversion to surgery occurred (2 after RFA and 11 after CHRT). Conclusions This is the first RCT evaluating the impact of upfront RFA in the multimodal treatment of LAPC. Compared to CHRT, RFA alone did not provide any advantage in terms of OS or PFS. It could be considered as a therapeutic option for LAPC within a multimodal context and after neoadjuvant therapies. |
| Databáze: | OpenAIRE |
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