A prospective, multi-institution assessment of irreversible electroporation for treatment of locally advanced pancreatic adenocarcinoma

initial outcomes from the AHPBA pancreatic registry

Michelle M. Holland, Neal Bhutiani, Edward James Kruse, Matthew J. Weiss, John D. Christein, Rebekah R. White, Kai Wen Huang, Robert C.G. Martin

Research output: Contribution to journalArticle

Abstract

Background: The optimal treatment and management of locally advanced pancreatic cancer (LAPC) remains unclear and controversial. This study aimed to report the initial outcomes of the AHPBA Registry and evaluate the reproducibility of existing evidence that the addition of Irreversible Electroporation (IRE), a nonthermal ablative treatment, confers survival benefits beyond standard therapeutic options for patients with LAPC. Methods: From December 2015 to October 2017, patients with LAPC were treated with open-technique IRE following the AHPBA Registry Protocols. Patient demographics, long-term outcomes, and adverse events were recorded. Survival analyses were performed using Kaplan-Meier (KM) curves for overall survival (OS), progression free survival (PFS) and time to progression (TTP). Results: A total of 152 patients underwent successful IRE. Morbidity and mortality were 18% and 2% respectively, with 19 (13%) patients experiencing severe adverse events. Nine (6%) patients presented with local recurrence. Median TTP, PFS, and OS from diagnosis were 27.3 months, 22.8 months, and 30.7 months respectively. Conclusion: The combination of IRE with established multiagent therapy is safe and demonstrates encouraging survival among patients with LAPC. IRE is associated with a low rate of serious adverse events and has been optimized for more widespread adoption through the standardized protocols available through the AHPBA registry.

Original languageEnglish (US)
Pages (from-to)1024-1031
Number of pages8
JournalHPB
Volume21
Issue number8
DOIs
StatePublished - Aug 1 2019

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Electroporation
Registries
Adenocarcinoma
Pancreatic Neoplasms
Therapeutics
Disease-Free Survival
Survival
Kaplan-Meier Estimate
Survival Analysis
Demography
Morbidity
Recurrence
Mortality

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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A prospective, multi-institution assessment of irreversible electroporation for treatment of locally advanced pancreatic adenocarcinoma : initial outcomes from the AHPBA pancreatic registry. / Holland, Michelle M.; Bhutiani, Neal; Kruse, Edward James; Weiss, Matthew J.; Christein, John D.; White, Rebekah R.; Huang, Kai Wen; Martin, Robert C.G.

In: HPB, Vol. 21, No. 8, 01.08.2019, p. 1024-1031.

Research output: Contribution to journalArticle

Holland, Michelle M. ; Bhutiani, Neal ; Kruse, Edward James ; Weiss, Matthew J. ; Christein, John D. ; White, Rebekah R. ; Huang, Kai Wen ; Martin, Robert C.G. / A prospective, multi-institution assessment of irreversible electroporation for treatment of locally advanced pancreatic adenocarcinoma : initial outcomes from the AHPBA pancreatic registry. In: HPB. 2019 ; Vol. 21, No. 8. pp. 1024-1031.
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abstract = "Background: The optimal treatment and management of locally advanced pancreatic cancer (LAPC) remains unclear and controversial. This study aimed to report the initial outcomes of the AHPBA Registry and evaluate the reproducibility of existing evidence that the addition of Irreversible Electroporation (IRE), a nonthermal ablative treatment, confers survival benefits beyond standard therapeutic options for patients with LAPC. Methods: From December 2015 to October 2017, patients with LAPC were treated with open-technique IRE following the AHPBA Registry Protocols. Patient demographics, long-term outcomes, and adverse events were recorded. Survival analyses were performed using Kaplan-Meier (KM) curves for overall survival (OS), progression free survival (PFS) and time to progression (TTP). Results: A total of 152 patients underwent successful IRE. Morbidity and mortality were 18{\%} and 2{\%} respectively, with 19 (13{\%}) patients experiencing severe adverse events. Nine (6{\%}) patients presented with local recurrence. Median TTP, PFS, and OS from diagnosis were 27.3 months, 22.8 months, and 30.7 months respectively. Conclusion: The combination of IRE with established multiagent therapy is safe and demonstrates encouraging survival among patients with LAPC. IRE is associated with a low rate of serious adverse events and has been optimized for more widespread adoption through the standardized protocols available through the AHPBA registry.",
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AU - Bhutiani, Neal

AU - Kruse, Edward James

AU - Weiss, Matthew J.

AU - Christein, John D.

AU - White, Rebekah R.

AU - Huang, Kai Wen

AU - Martin, Robert C.G.

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N2 - Background: The optimal treatment and management of locally advanced pancreatic cancer (LAPC) remains unclear and controversial. This study aimed to report the initial outcomes of the AHPBA Registry and evaluate the reproducibility of existing evidence that the addition of Irreversible Electroporation (IRE), a nonthermal ablative treatment, confers survival benefits beyond standard therapeutic options for patients with LAPC. Methods: From December 2015 to October 2017, patients with LAPC were treated with open-technique IRE following the AHPBA Registry Protocols. Patient demographics, long-term outcomes, and adverse events were recorded. Survival analyses were performed using Kaplan-Meier (KM) curves for overall survival (OS), progression free survival (PFS) and time to progression (TTP). Results: A total of 152 patients underwent successful IRE. Morbidity and mortality were 18% and 2% respectively, with 19 (13%) patients experiencing severe adverse events. Nine (6%) patients presented with local recurrence. Median TTP, PFS, and OS from diagnosis were 27.3 months, 22.8 months, and 30.7 months respectively. Conclusion: The combination of IRE with established multiagent therapy is safe and demonstrates encouraging survival among patients with LAPC. IRE is associated with a low rate of serious adverse events and has been optimized for more widespread adoption through the standardized protocols available through the AHPBA registry.

AB - Background: The optimal treatment and management of locally advanced pancreatic cancer (LAPC) remains unclear and controversial. This study aimed to report the initial outcomes of the AHPBA Registry and evaluate the reproducibility of existing evidence that the addition of Irreversible Electroporation (IRE), a nonthermal ablative treatment, confers survival benefits beyond standard therapeutic options for patients with LAPC. Methods: From December 2015 to October 2017, patients with LAPC were treated with open-technique IRE following the AHPBA Registry Protocols. Patient demographics, long-term outcomes, and adverse events were recorded. Survival analyses were performed using Kaplan-Meier (KM) curves for overall survival (OS), progression free survival (PFS) and time to progression (TTP). Results: A total of 152 patients underwent successful IRE. Morbidity and mortality were 18% and 2% respectively, with 19 (13%) patients experiencing severe adverse events. Nine (6%) patients presented with local recurrence. Median TTP, PFS, and OS from diagnosis were 27.3 months, 22.8 months, and 30.7 months respectively. Conclusion: The combination of IRE with established multiagent therapy is safe and demonstrates encouraging survival among patients with LAPC. IRE is associated with a low rate of serious adverse events and has been optimized for more widespread adoption through the standardized protocols available through the AHPBA registry.

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