Tumour cryoablation combined with palliative bypass surgery in the treatment of unresectable pancreatic cancer: a retrospective study of 142 patients
- Jingdong Li1,
- Xiaoli Chen2,
- Hanfeng Yang1,
- Xiaofei Wang1,
- Ding Yuan2,
- Yong Zeng2,
- Tianfu Wen2,
- Lunan Yan2,
- Bo Li2
- 1Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical Collage, Nanchong, China
- 2Department of General Surgery, West China Hospital of Sichuan University, Chengdu, China
- Correspondence to Professor Bo Li, Department of General Surgery, West China Hospital of Sichuan University, Chengdu 610041, China;
- Received 27 January 2010
- Accepted 8 October 2010
- Published Online First 3 December 2010
Background Although cryosurgery has been proved to be an effective treatment to extend the survival time of unresectable liver cancer patients and improve their quality of life, few surgeons actually treat unresectable pancreatic cancer with this method because of its safety risks. This study aims to evaluate the safety and efficacy of cryosurgical ablation in the treatment for unresectable pancreatic cancer.
Methods A retrospective study was conducted on 142 patients who underwent palliative bypass with cryoablation (PBC group: 68) or without cryoablation (PB group: 74) for unresectable pancreatic cancer from 1995 to 2002. The morbidity and 5 year survival rates of the two groups were compared. Carbohydrate antigen 19–9 (CA19-9) level and tumour size were evaluated in PBC group.
Results There was no significant difference in the rate of overall complications between the two groups (p=0.809), except for a higher delayed gastric emptying rate observed in the PBC group (36.8% vs 16.2%, p=0.005). In the PBC group, the median preoperative CA19-9 concentration decreased from 690 U/ml to 56 U/ml (p=0.000). CT scan results of 55 patients indicated that tumour mass shrinkage occurred in 36 of them, from 4.3 cm to 2.4 cm (pre-ablation to 3 months after ablation). Kaplan–Meier analysis showed no significant difference in 5 year survival rates between the two groups (p=0.124).
Conclusions Cryosurgery combined with palliative bypass surgery can be considered a safe and effective treatment for unresectable pancreatic cancer. Though this technique remains only palliative, it may be further employed to improve advanced stage pancreatic cancer.
Competing interests None declared.
Ethics approval This study was conducted with the approval of the Ethics Committee of Sichuan University.
Provenance and peer review Not commissioned; externally peer reviewed.