Clinical Review State of the Art Review

Stage III pancreatic cancer and the role of irreversible electroporation

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h521 (Published 18 March 2015) Cite this as: BMJ 2015;350:h521
  1. Mohammad Al Efishat, general surgery resident,
  2. Christopher L Wolfgang, associate professor of surgery and oncology, director of hepatobiliary and pancreatic surgery,
  3. Matthew J Weiss, assistant professor of surgery and oncology
  1. 1Department of Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA
  1. Correspondences to: M J Weiss mweiss5{at}jhmi.edu

Abstract

About a third of patients with pancreatic cancer present with locally advanced disease that is not amenable to resection. Because these patients have localized disease, conventional ablative therapies (thermal ablation and cryoablation) have the potential to be beneficial, but their use is inherently limited in the pancreas. These limitations could be overcome by irreversible electroporation—a novel, non-thermal ablative method that is gaining popularity for the treatment of many soft tissue tumors, including those of the pancreas. This review summarizes the status of this technique in the treatment of locally advanced pancreatic cancer. Most of the evidence on efficacy and safety is based on non-randomized prospective series, which show that irreversible electroporation may improve overall survival and pain control in locally advanced pancreatic cancer. As experience with this procedure increases, randomized controlled trials are needed to document its efficacy in locally advanced pancreatic cancer more precisely.

Footnotes

  • Contributors: All authors helped plan, conduct, write, and review this paper. All authors approved the final version. MJW is guarantor.

  • Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: none.

  • Provenance and peer review: Commissioned; externally peer reviewed.

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