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Treatment of 200 Locally Advanced (Stage III) Pancreatic Adenocarcinoma Patients with Irreversible Electroporation: Safety and Efficacy
Robert CG Martin1, David Kwon*2, Sricharan Chalikonda*3, Marty Sellars*4, Eric Kortz*5, Charles R Scoggins1, Kevin T Watkins*6, Kelly M McMasters1
1University of Louisville, Louisville, KY;2Henry Ford Hospital Department of Surgery, Detroit, MI;3Cleveland Clinic Department of Surgery, Cleveland, OH;4Piedmont Hospital Department of Surgery, Atlanta, GA;5Swedish Medical Center Department of Surgery, Denver, CO;6Cancer Treatment Centers of America, Atlanta, GA

Objectives: Ablative therapies have been increasingly utilized in treatment of locally advanced pancreatic cancer(LAPC). Irreversible Electroporation(IRE) is an energy delivery system, effective in ablating tumors by inducing irreversible cell membrane destruction of cells. We aimed to demonstrate efficacy of treatment with IRE as part of multimodal treatment of LAPC.
Methods: From July 2010 to October 2014, patients with radiographic stage III LAPC were treated with IRE and monitored under a multicenter, prospective IRB-approved registry. Perioperative 90-day outcomes, local failure, and overall survival were recorded and compared to standard of care data for stage III LAPC.
Results: 200 patients with LAPC underwent IRE of tumor(In-Situ, n=150) or IRE with pancreatic ±arterial resection(Margin, n=50). All patients underwent induction chemotherapy, with an additional 52% receiving chemo-radiation, for a median of 7 months(range, 5-13) prior to IRE(Figure). IRE was successfully administered to all patients. 19% sustained complications with a median grade of 2(range, 1-3). Median length of stay was 6 days (range, 4-58). With a median follow up of 25 months, 6(3%) had local recurrence. Median overall survival(OS) in both groups was 23.5 months(Figure).
Conclusion: In stage II LAPC, the addition of IRE with established chemotherapy and/or radiation therapy can provide a significant survival advantage. These early outcome metrics and overall survival begin to establish the minimal standards in which to establish future comparative studies.


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