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The efficacy and safety of the open approach irreversible electroporation in the treatment of pancreatic cancer: A systematic review.

Publication ,  Journal Article
Charalambous, P; Moris, D; Karachaliou, G-S; Papalampros, A; Dimitrokallis, N; Tsilimigras, DI; Oikonomou, D; Petrou, A
Published in: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
September 2020

Irreversible Electroporation (IRE) is a novel non-thermal ablation technique used in patients with locally advanced pancreatic cancer (LAPC), in the proximity of sensitive structures such as vessels, intestinal wall and the bile duct. Currently, it is only used in the setting of clinical trials. This systematic review aimed to tackle the knowledge gap in the literature, in relation to the safety and efficacy of the open approach IRE.MEDLINE, EMBASE and Cochrane libraries were searched for English language articles published from January 2000 to December 2019. Data related to safety and efficacy were extracted.Nine studies involving 460 patients with LAPC were included. Open approach IRE was associated with high morbidity (29.4%) but with a survival benefit compared to traditional treatment. Median overall survival (OS) was at 17.15 months. Major morbidity was at 10.2% and mortality at 3.4%.Despite the paucity of literature and the low quality of evidence, the results regarding safety and efficacy appear to be encouraging. The high morbidity seems to be mitigated by a demonstrated improvement in OS. The potential of this technique is more evident when mortality and major morbidity are considered, since they are at acceptable levels. The limitations of this review have made it difficult to extract definitive conclusions. Higher quality evidence is needed in the form of large-scale multicentre randomized controlled trials. It remains to be elucidated whether the rate of adverse events decreases as our experience with this technique increases.

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Published In

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

DOI

EISSN

1532-2157

ISSN

0748-7983

Publication Date

September 2020

Volume

46

Issue

9

Start / End Page

1565 / 1572

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Progression-Free Survival
  • Postoperative Complications
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Mortality
  • Length of Stay
  • Humans
 

Citation

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Charalambous, P., Moris, D., Karachaliou, G.-S., Papalampros, A., Dimitrokallis, N., Tsilimigras, D. I., … Petrou, A. (2020). The efficacy and safety of the open approach irreversible electroporation in the treatment of pancreatic cancer: A systematic review. European Journal of Surgical Oncology : The Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 46(9), 1565–1572. https://doi.org/10.1016/j.ejso.2020.05.017
Charalambous, Pabos, Dimitrios Moris, Georgia-Sofia Karachaliou, Alexandros Papalampros, Nikolaos Dimitrokallis, Diamantis I. Tsilimigras, Dimitrios Oikonomou, and Athanasios Petrou. “The efficacy and safety of the open approach irreversible electroporation in the treatment of pancreatic cancer: A systematic review.European Journal of Surgical Oncology : The Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 46, no. 9 (September 2020): 1565–72. https://doi.org/10.1016/j.ejso.2020.05.017.
Charalambous P, Moris D, Karachaliou G-S, Papalampros A, Dimitrokallis N, Tsilimigras DI, et al. The efficacy and safety of the open approach irreversible electroporation in the treatment of pancreatic cancer: A systematic review. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2020 Sep;46(9):1565–72.
Charalambous, Pabos, et al. “The efficacy and safety of the open approach irreversible electroporation in the treatment of pancreatic cancer: A systematic review.European Journal of Surgical Oncology : The Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 46, no. 9, Sept. 2020, pp. 1565–72. Epmc, doi:10.1016/j.ejso.2020.05.017.
Charalambous P, Moris D, Karachaliou G-S, Papalampros A, Dimitrokallis N, Tsilimigras DI, Oikonomou D, Petrou A. The efficacy and safety of the open approach irreversible electroporation in the treatment of pancreatic cancer: A systematic review. European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2020 Sep;46(9):1565–1572.
Journal cover image

Published In

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

DOI

EISSN

1532-2157

ISSN

0748-7983

Publication Date

September 2020

Volume

46

Issue

9

Start / End Page

1565 / 1572

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Progression-Free Survival
  • Postoperative Complications
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Mortality
  • Length of Stay
  • Humans