The outcome of cryoablation in treating advanced pancreatic cancer: a comparison with palliative bypass surgery alone

J Dig Dis. 2014 Oct;15(10):561-9. doi: 10.1111/1751-2980.12170.

Abstract

Objective: This study aimed to investigate the efficacy and safety of palliative bypass surgery combined with cryoablation in treating patients with advanced pancreatic cancer and compare this combination therapy with palliative bypass surgery alone.

Methods: Medical records of 118 patients with advanced pancreatic cancer who received palliative bypass surgery combined with cryoablation (the combination treatment group) or bypass surgery alone (the bypass surgery alone group) at the Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) were retrospectively reviewed. Their baseline and peri-operative parameters were collected and compared.

Results: In both groups abdominal distension and pain was significantly ameliorated after treatment. Preoperative jaundice was more common in the bypass surgery group while backache was more frequent in the combination treatment group, which were both relieved by treatment. The pre-operative serum bilirubin level was higher in the bypass surgery group and was decreased significantly after treatment. However, a significant reduction in tumor size and serum carbohydrate antigen 19-9 level was found only in the combination treatment group. There was no significant difference in the incidence of postoperative complications and prognosis between the two groups.

Conclusions: Cryoablation can reduce tumor size and relieve the patients' symptoms and signs such as abdominal discomfort and backache, although it could not improve the patients' prognosis significantly. It is a safe and efficient modality when combined with bypass surgery for patients with advanced pancreatic cancer.

Keywords: bypass surgery; complication; cryosurgery; pancreatic neoplasms.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Combined Modality Therapy
  • Cryosurgery / adverse effects
  • Cryosurgery / methods*
  • Female
  • Gastroenterostomy / adverse effects
  • Gastroenterostomy / methods
  • Humans
  • Jejunostomy / methods
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Prognosis
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome