Radiofrequency ablation of stage III pancreatic carcinoma: a new path to follow?

RADIOFREQUENCY ABLATION IN STAGE III PANCREATIC CARCINOMA: A NEW PATH TO FOLLOW? Frigerio I. Pancreatic cancer has a poor prognosis even when diagnosis is made at early stages because of its systemic nature. Surgery plays an essential role when resection is feasible and palliative chemotherapy is supportive for metastatic disease. May the large group of patients with locally advanced disease benefit of a local treatment? We applied radiofrequency to ablate locally advanced pancreatic carcinoma: we first defined a reproducible and safe model of the technique by treating 50 patients. In this first part of our study mortality rate 2% was and RFA-related morbidity rate was 12%. Because of the feeling that these patients survived longer than expected we looked at survival rate and found that overall survival in the first 100 patients was 20 months and disease specific survival was 23 months, significantly higher than survival of patients undergone to traditional therapy. Up to now we have treated 182 patients with no significative differences in morbidity and mortality rate and survival rate. RFA is always associated to systemic chemotherapy and external radiotherapy. RFA alone is not enough but it is one part of a multimodality treatment which includes chemo and radiotherapy. Different aspects related to interaction between RFA and cancer arose since when we started in 2007: the most promising is the immune modulation operated by RFA. We think that future studies must investigate this field together with a randomized study that will confirm or not this impressive data of survival rate.