Cryoablation of unresectable pancreatic cancer.
Kovach SJ, Hendrickson RJ, Cappadona CR, Schmidt CM, Groen K, Koniaris
LG, Sitzmann JV.
Department of Surgery, University of Rochester Medical Center, Box
SURG, 601 Elmwood Avenue, Rochester, NY 14642, USA.
BACKGROUND: Most patients with pancreatic cancer
are not candidates for curative resection. The goal of this study
was to evaluate the safety of an intraoperative ultrasound-guided
cryosurgical procedure in a phase I study of unresectable pancreatic
cancer. METHODS: From March 1995 to March 1999, 10 cryosurgeries
using intraoperative ultrasound were performed on 9 patients with
unresectable cancers at laparotomy. Four patients had a concurrent
gastrojejunostomy, 2 had a chemical splanchnicectomy, and 1 underwent
a concurrent hepatic cryosurgical procedure. RESULTS: There was
no intraoperative morbidity or mortality. No patients developed
postoperative pancreatitis or fistula. All patients had good pain
control postoperatively and were tolerating a regular diet at the
time of discharge. Pain control at discharge was achieved with an
oral formulation (4/9), transdermal patch (3/9), no pain medication
(1/9), and intravenous patient controlled analgesia (1/9). CONCLUSIONS:
Ultrasound-guided cryoablation for unresectable pancreatic cancer
appears safe and may contribute to improved postoperative pain control.
Future studies to determine its therapeutic role in the management
of unresectable pancreatic cancer are indicated.
· Clinical Trial
· Clinical Trial, Phase I
PMID: 11935137 [PubMed - indexed for MEDLINE]