Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma

Govindarajan Narayanan, Peter Hosein, Isabelle C. Beulaygue, Tatiana Froud, Hester J. Scheffer, Shree Venkat, Ana Echenique, Elizabeth C. Hevert, Alan Livingstone, Caio M. Rocha-Lima, Jaime R Merchan, Joe Levi, Jose Yrizarry, Riccardo Lencioni

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.

Original languageEnglish (US)
Pages (from-to)342-348
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume28
Issue number3
DOIs
StatePublished - Mar 1 2017

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Electroporation
Adenocarcinoma
Survival
Safety
Therapeutics
Tomography
Confidence Intervals
Neoplasms
Pancreatitis
Abdominal Pain
Sepsis
Stomach
Radiotherapy
Multivariate Analysis
Retrospective Studies
Biopsy
Drug Therapy
Mortality

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma. / Narayanan, Govindarajan; Hosein, Peter; Beulaygue, Isabelle C.; Froud, Tatiana; Scheffer, Hester J.; Venkat, Shree; Echenique, Ana; Hevert, Elizabeth C.; Livingstone, Alan; Rocha-Lima, Caio M.; Merchan, Jaime R; Levi, Joe; Yrizarry, Jose; Lencioni, Riccardo.

In: Journal of Vascular and Interventional Radiology, Vol. 28, No. 3, 01.03.2017, p. 342-348.

Research output: Contribution to journalArticle

Narayanan, Govindarajan ; Hosein, Peter ; Beulaygue, Isabelle C. ; Froud, Tatiana ; Scheffer, Hester J. ; Venkat, Shree ; Echenique, Ana ; Hevert, Elizabeth C. ; Livingstone, Alan ; Rocha-Lima, Caio M. ; Merchan, Jaime R ; Levi, Joe ; Yrizarry, Jose ; Lencioni, Riccardo. / Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma. In: Journal of Vascular and Interventional Radiology. 2017 ; Vol. 28, No. 3. pp. 342-348.
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abstract = "Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60{\%}) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20{\%}) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95{\%} confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95{\%} CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.",
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T1 - Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma

AU - Narayanan, Govindarajan

AU - Hosein, Peter

AU - Beulaygue, Isabelle C.

AU - Froud, Tatiana

AU - Scheffer, Hester J.

AU - Venkat, Shree

AU - Echenique, Ana

AU - Hevert, Elizabeth C.

AU - Livingstone, Alan

AU - Rocha-Lima, Caio M.

AU - Merchan, Jaime R

AU - Levi, Joe

AU - Yrizarry, Jose

AU - Lencioni, Riccardo

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.

AB - Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.

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