Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma

Govindarajan Narayanan, Peter J. Hosein, Isabelle C. Beulaygue, Tatiana Froud, Hester J. Scheffer, Shree R. Venkat, Ana M. Echenique, Elizabeth C. Hevert, Alan S. Livingstone, Caio M. Rocha-Lima, Jaime R. Merchan, Joseph U. Levi, Jose M. Yrizarry, Riccardo Lencioni

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.

Original languageEnglish
Pages (from-to)342-348
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume28
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Cite this

Narayanan, Govindarajan ; Hosein, Peter J. ; Beulaygue, Isabelle C. ; Froud, Tatiana ; Scheffer, Hester J. ; Venkat, Shree R. ; Echenique, Ana M. ; Hevert, Elizabeth C. ; Livingstone, Alan S. ; Rocha-Lima, Caio M. ; Merchan, Jaime R. ; Levi, Joseph U. ; Yrizarry, Jose M. ; Lencioni, Riccardo. / Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma. In: Journal of Vascular and Interventional Radiology. 2017 ; Vol. 28, No. 3. pp. 342-348.
@article{3ab428d7f220450897c483aa4212015e,
title = "Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma",
abstract = "Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60{\%}) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20{\%}) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95{\%} confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95{\%} CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.",
author = "Govindarajan Narayanan and Hosein, {Peter J.} and Beulaygue, {Isabelle C.} and Tatiana Froud and Scheffer, {Hester J.} and Venkat, {Shree R.} and Echenique, {Ana M.} and Hevert, {Elizabeth C.} and Livingstone, {Alan S.} and Rocha-Lima, {Caio M.} and Merchan, {Jaime R.} and Levi, {Joseph U.} and Yrizarry, {Jose M.} and Riccardo Lencioni",
year = "2017",
month = "3",
day = "1",
doi = "10.1016/j.jvir.2016.10.023",
language = "English",
volume = "28",
pages = "342--348",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "3",

}

Narayanan, G, Hosein, PJ, Beulaygue, IC, Froud, T, Scheffer, HJ, Venkat, SR, Echenique, AM, Hevert, EC, Livingstone, AS, Rocha-Lima, CM, Merchan, JR, Levi, JU, Yrizarry, JM & Lencioni, R 2017, 'Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma' Journal of Vascular and Interventional Radiology, vol. 28, no. 3, pp. 342-348. https://doi.org/10.1016/j.jvir.2016.10.023

Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma. / Narayanan, Govindarajan; Hosein, Peter J.; Beulaygue, Isabelle C.; Froud, Tatiana; Scheffer, Hester J.; Venkat, Shree R.; Echenique, Ana M.; Hevert, Elizabeth C.; Livingstone, Alan S.; Rocha-Lima, Caio M.; Merchan, Jaime R.; Levi, Joseph U.; Yrizarry, Jose M.; Lencioni, Riccardo.

In: Journal of Vascular and Interventional Radiology, Vol. 28, No. 3, 01.03.2017, p. 342-348.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Percutaneous Image-Guided Irreversible Electroporation for the Treatment of Unresectable, Locally Advanced Pancreatic Adenocarcinoma

AU - Narayanan, Govindarajan

AU - Hosein, Peter J.

AU - Beulaygue, Isabelle C.

AU - Froud, Tatiana

AU - Scheffer, Hester J.

AU - Venkat, Shree R.

AU - Echenique, Ana M.

AU - Hevert, Elizabeth C.

AU - Livingstone, Alan S.

AU - Rocha-Lima, Caio M.

AU - Merchan, Jaime R.

AU - Levi, Joseph U.

AU - Yrizarry, Jose M.

AU - Lencioni, Riccardo

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.

AB - Purpose To describe safety and effectiveness of percutaneous irreversible electroporation (IRE) for treatment of unresectable, locally advanced pancreatic adenocarcinoma (LAPC). Materials and Methods This retrospective study included 50 patients (23 women, 27 men; age range, 46–91 y; median age, 62.5 y) with biopsy-proven, unresectable LAPC who received percutaneous computed tomography (CT)–guided IRE. The primary objective was to assess the safety profile of the procedure; the secondary objective was to determine overall survival (OS). All patients had prior chemotherapy (1–5 lines, median 2), and 30 (60%) of 50 patients had prior radiation therapy. Follow-up included CT at 1 month and at 3-month intervals thereafter. Results There were no treatment-related deaths and no 30-day mortality. Serious adverse events occurred in 10 (20%) of 50 patients (abdominal pain [n = 7], pancreatitis [n = 1], sepsis [n = 1], gastric leak [n = 1]). Median OS was 27.0 months (95% confidence interval [CI], 22.7–32.5 months) from time of diagnosis and 14.2 months (95% CI, 9.7–16.2 months) from time of IRE. Patients with tumors ≤ 3 cm (n = 24) had significantly longer median OS than patients with tumors > 3 cm (n = 26): 33.8 vs 22.7 months from time of diagnosis (P =.002) and 16.2 vs 9.9 months from time of IRE (P =.031). Tumor size was confirmed as the only independent predictor of OS at multivariate analysis. Conclusions Percutaneous image-guided IRE of unresectable LAPC is associated with an acceptable safety profile.

UR - http://www.scopus.com/inward/record.url?scp=85007579613&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2016.10.023

DO - 10.1016/j.jvir.2016.10.023

M3 - Article

VL - 28

SP - 342

EP - 348

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 3

ER -