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Radiofrequency Ablation of Pancreatic Mass

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Diagnosis and Endoscopic Management of Digestive Diseases

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Abstract

Stage III pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, and no gold standard treatment has been established so far. Radiofrequency ablation (RFA) is a new treatment option for locally advanced pancreatic cancer (LAPC), but its application is still very limited. We report our experience on 200 patients treated with pancreatic RFA as cytoreductive intent associated with chemoradiotherapy in a multimodal setting. In our series, median survival was 19 months and progression-free survival was 13 months. The results do not seem to depend on the rate of the ablated area. Postoperative course was uneventful in 76 % of cases, abdominal complications occurred in 23 % of patients, and the mortality rate was 2 %. However, after the last technical changes (temperature 80 °C, limited ablation, use of single cool-tip needle, safety distance from the duodenum), we found a significant reduction of morbidity (from 25% to 13%) and mortality (from 2% to 0%). RFA with endoscopic ultrasound approach (EUS-RFA) has been recently proposed, but the experience is still very limited. The advantages of EUS-RFA are being a less invasive approach, more precise placement of the needle due to high-resolution images, and short hospital stay. Moreover, the procedure is potentially repeatable.

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Authors and Affiliations

  1. Hepato-Pancreato-Biliary Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy

    Roberto Girelli

  2. Pederzoli Hospital, Peschiera del Garda, Verona, Italy

    Frigerio Isabella, Alessandro Giardino, Paolo Regi, Filippo Scopelliti & Giovanni Butturini

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  1. Roberto Girelli
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  3. Alessandro Giardino
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  4. Paolo Regi
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  5. Filippo Scopelliti
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  6. Giovanni Butturini
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Correspondence to Roberto Girelli .

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  1. S. Agostino Estense Hospital, Modena, Italy

    Rita Conigliaro

  2. S. Agostino Estense Hospital, Modena, Italy

    Marzio Frazzoni

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Girelli, R., Isabella, F., Giardino, A., Regi, P., Scopelliti, F., Butturini, G. (2017). Radiofrequency Ablation of Pancreatic Mass. In: Conigliaro, R., Frazzoni, M. (eds) Diagnosis and Endoscopic Management of Digestive Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-42358-6_3

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  • DOI: https://doi.org/10.1007/978-3-319-42358-6_3

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