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Systematic Review

Margin Accentuation Irreversible Electroporation in Stage III Pancreatic Cancer: A Systematic Review

1
Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
2
Hepato-Pancreato-Biliary and Transplant Unit, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK
3
Department of Interventional Radiology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK
4
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4AX, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Maria Gazouli
Cancers 2021, 13(13), 3212; https://doi.org/10.3390/cancers13133212
Received: 14 May 2021 / Revised: 14 June 2021 / Accepted: 24 June 2021 / Published: 27 June 2021
(This article belongs to the Section Systematic Review or Meta-Analysis in Cancer Research)
This literature review shows preliminary evidence to suggest that electroporation, the use of electricity to cause the death of cells around the tumour, may be associated with an improved survival and complete resection rates following pancreatic surgery for higher stage pancreatic cancer. However, one in five patients have a complication from the procedure that alters their normal course in hospital. Moreover, the number of patients who underwent this technique is small and further data is needed to support the preliminary evidence. The results therefore should be interpreted with caution.
The present systematic review aimed to summarise the available evidence on indications and oncological outcomes after MA IRE for stage III pancreatic cancer (PC). A literature search was performed in the Pubmed, MEDLINE, EMBASE, SCOPUS databases using the PRISMA framework to identify all MA IRE studies. Nine studies with 235 locally advanced (LA) (82%, 192/235) or Borderline resectable (BR) PC (18%, 43/235) patients undergoing MA IRE pancreatic resection were included. Patients were mostly male (56%) with a weighted-mean age of 61 years (95% CI: 58–64). Pancreatoduodenectomy was performed in 51% (120/235) and distal pancreatectomy in 49% (115/235). R0 resection rate was 73% (77/105). Clavien Dindo grade 3–5 postoperative complications occurred in 19% (36/187). Follow-up intervals ranged from 3 to 29 months. Local and systematic recurrences were noted in 8 and 43 patients, respectively. The weighted-mean progression free survival was 11 months (95% CI: 7–15). The weighted-mean overall survival was 22 months (95% CI 20–23 months) and 8 months (95% CI 1–32 months) for MA IRE and IRE alone, respectively. Early non-randomised data suggest MA IRE during pancreatic surgery for stage III pancreatic cancer may result in increased R0 resection rates and improved OS with acceptable postoperative morbidity. Further, larger studies are warranted to corroborate this evidence. View Full-Text
Keywords: irreversible electroporation; margin accentuation; pancreatic cancer; pancreatic surgery irreversible electroporation; margin accentuation; pancreatic cancer; pancreatic surgery
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MDPI and ACS Style

Ratnayake, B.; Al-Leswas, D.; Mohammadi-Zaniani, G.; Littler, P.; Sen, G.; Manas, D.; Pandanaboyana, S. Margin Accentuation Irreversible Electroporation in Stage III Pancreatic Cancer: A Systematic Review. Cancers 2021, 13, 3212. https://doi.org/10.3390/cancers13133212

AMA Style

Ratnayake B, Al-Leswas D, Mohammadi-Zaniani G, Littler P, Sen G, Manas D, Pandanaboyana S. Margin Accentuation Irreversible Electroporation in Stage III Pancreatic Cancer: A Systematic Review. Cancers. 2021; 13(13):3212. https://doi.org/10.3390/cancers13133212

Chicago/Turabian Style

Ratnayake, Bathiya, Dhya Al-Leswas, Ghazaleh Mohammadi-Zaniani, Peter Littler, Gourab Sen, Derek Manas, and Sanjay Pandanaboyana. 2021. "Margin Accentuation Irreversible Electroporation in Stage III Pancreatic Cancer: A Systematic Review" Cancers 13, no. 13: 3212. https://doi.org/10.3390/cancers13133212

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