IRREVERSIBLE ELECTROPORATION FIRST STEPS TOWARDS CELLULAR SURGERY

The permeability of the cell membrane could be increased by intense but short electrical fields in a process called electroporation. Irreversible electroporation (IRE) is a tissue ablation technique in which electrical pulses are delivered to undesirable tissue to produce cell necrosis through irreversible cell membrane permeabilization that leads to cell apoptosis and has recently begun to emerge as an important minimally invasive non-thermal ablation technique. Treatment options for locally advanced pancreatic cancer are limited and plenty of complications and survival and quality of life of these patients still remains really poor despite advances in cancer multimodal therapies. Ten patients with unresectable non metastatic pancreatic cancer non responsive to chemo or chemoradiotherapy were enrolled: they underwent IRE application using Nanoknife System during laparotomy. The purpose of this study was to evaluate the safety and feasibility of the IRE to treat locally advanced pancreatic cancer. The IRE application was well-tolerated in all patients and there were no procedural or immediate post-procedural complications; the most frequent adverse event was abdominal pain after procedure. Mean time from treatment to death was 7.6 months and mean time from diagnosis to death was 16.8 months; overall survival of our patients was longer compared with a group of patients who received palliative surgery and chemotherapy and with overall survival in literature of patients in the same stage treated with chemo/chemoradiotherapy protocols alone.