Related Experiment Video
Updated: Mar 15, 2026
Laparoscopic Pancreatoduodenectomy for Pancreatic Cancer Using In-Situ No-Touch Isolation Technique
Published on: February 2, 2022
Ablation of the locally advanced pancreatic cancer: An introduction and brief summary of techniques
Athanasios Petrou1, Demetrios Moris, Patrick Paul Tabet
1Surgery Department, New Nicosia General Hospital, Limassol Old Road No. 215, Strovolos, 2029 Nicosia, Cyprus.
Abstract:
Pancreatic ductal adenocarcinoma is a lethal and late presenting malignancy with dismal survival rates. An estimated total of 330,000 people died from this malignancy in 2012. Although there have been improvements in diagnostic and treatment methods, the survival of late stage pancreatic cancer has not shown significant improvement in the past 4 decades. Multiple treatment approaches are available including chemotherapy, radiotherapy, and immunotherapy, but to this day surgical resection remains the only curative treatment option. Ablative techniques use various forms of energy to cause local tissue destruction through necrosis or apoptosis. They are relevant in pancreatic ductal adenocarcinoma as they are a treatment option in non-resectable tumors where their use ranges from symptom control to reducing tumor size for resection. In this narrative review we have grouped and outlined the various ablative methods, classifying them into thermal (Radiofrequency ablation, Microwave ablation, High Intensity Focused Ultrasound ablation, Cryoablation), and non-thermal ablative methods (Irreversible Electroporation (NanoKnife®), Photodynamic Therapy). This is followed by a description and review of the available evidence on survival and complications for each of these ablative methods. According to the literature, thermal ablative methods appear to be more accessible but are implicated with more complications than non thermal ablative methods which show the most promise.
Insights
Pancreatic cancer treatments are limited, but ablative techniques offer new options for non-resectable tumors. Non-thermal ablation shows promise with fewer complications than thermal methods for pancreatic ductal adenocarcinoma.
Area of Science:
- Oncology
- Surgical Innovation
- Medical Technology
Background:
- Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer with poor survival rates.
- Despite advances, late-stage PDAC survival has seen minimal improvement over four decades.
- Surgical resection is the only curative option, but many tumors are non-resectable.
Purpose of the Study:
- To review and categorize various ablative techniques for pancreatic cancer.
- To analyze the survival and complication data for each ablative method.
- To compare thermal and non-thermal ablative approaches in PDAC management.
Main Methods:
- Narrative review of ablative techniques for PDAC.
- Classification into thermal (RFA, MA, HIFU, Cryoablation) and non-thermal (IRE, PDT) methods.
- Evidence synthesis on survival outcomes and complications for each modality.
Main Results:
- Ablative techniques are viable for non-resectable PDAC, aiding symptom control and tumor debulking.
- Thermal ablative methods are accessible but associated with higher complication rates.
- Non-thermal ablative methods, particularly Irreversible Electroporation, demonstrate significant promise.
Conclusions:
- Ablative therapies represent a crucial treatment avenue for non-resectable pancreatic cancer.
- Non-thermal ablative techniques offer a potentially safer and more effective alternative to thermal methods.
- Further research into non-thermal ablation is warranted to optimize PDAC treatment strategies.
