Systematic review of novel ablative methods in locally advanced pancreatic cancer

World J Gastroenterol. 2014 Mar 7;20(9):2267-78. doi: 10.3748/wjg.v20.i9.2267.


Unresectable locally advanced pancreatic cancer with or without metastatic disease is associated with a very poor prognosis. Current standard therapy is limited to chemotherapy or chemoradiotherapy. Few regimens have been shown to have a substantial survival advantage and novel treatment strategies are urgently needed. Thermal and laser based ablative techniques are widely used in many solid organ malignancies. Initial studies in the pancreas were associated with significant morbidity and mortality, which limited widespread adoption. Modifications to the various applications, in particular combining the techniques with high quality imaging such as computed tomography and intraoperative or endoscopic ultrasound has enabled real time treatment monitoring and significant improvements in safety. We conducted a systematic review of the literature up to October 2013. Initial studies suggest that ablative therapies may confer an additional survival benefit over best supportive care but randomised studies are required to validate these findings.

Keywords: Cryoablation; High frequency focused ultrasound; Irreversible electroporation; Microwave ablation; Pancreatic cancer; Photodynamic therapy; Radiofrequency ablation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Ablation Techniques*
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / surgery*
  • Catheter Ablation
  • Cryosurgery
  • Electroporation
  • High-Intensity Focused Ultrasound Ablation
  • Humans
  • Laser Therapy
  • Microwaves / therapeutic use
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Precancerous Conditions / pathology
  • Precancerous Conditions / surgery*
  • Treatment Outcome