Gastrointestinal endoscopy · 2025
One-year survival rate of unresectable pancreatic cancer size 4 cm or smaller treated with or without EUS-radiofrequency ablation.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Kongkam Pradermchai, Tantitanawat Kittithat, Kerr Stephen, Lopimpisuth Chawin, Tiankanon Kasenee, Angsuwatcharakon Phonthep, Ridtitid Wiriyaporn, Mekaroonkamol Parit, Teeyapun Nattaya, Tanasanvimon Suebpong, Treeprasertsuk Sombat, Kullavanijaya Pinit, Sriuranpong Virote, Rerknimitr Rungsun, Luangsukrerk Thanawat
Аннотация
BACKGROUND AND AIMS: The prognosis for unresectable pancreatic ductal adenocarcinoma (UPDAC) remains poor with current treatments. This study evaluates the survival benefits of EUS-guided radiofrequency ablation (RFA) in UPDAC ≤4 cm.
METHODS: A prospective series of patients who underwent EUS-RFA (January 2017 to September 2022) was compared with controls. Propensity score matching was applied using tumor size, staging, age-adjusted Charlson Comorbidity Index, and chemotherapy regimen. Inverse probability weighting was used to estimate treatment effects on survival, local progression, and response rates.
RESULTS: Among 47 patients (12 EUS-RFA, 35 controls), median survival was 13.4 months in the EUS-RFA group versus 7.7 months for controls (hazard ratio, 0.50; P = .03). The survival probability at 12 months was 58% in the EUS-RFA group versus 22% for controls (P = .04). Adverse events were mild abdominal pain in 10% of RFA operations.
CONCLUSIONS: EUS-RFA as an adjunct for UPDAC ≤4 cm may improve survival with minimal side effects. (Trial registration: The study was a secondary exploratory analysis of a clinical trial registered at Thai Clinical Trials Registry (https://www.thaiclinicaltrials.org/show/TCTR20180706001) with clinical trial number 20180706001.).
METHODS: A prospective series of patients who underwent EUS-RFA (January 2017 to September 2022) was compared with controls. Propensity score matching was applied using tumor size, staging, age-adjusted Charlson Comorbidity Index, and chemotherapy regimen. Inverse probability weighting was used to estimate treatment effects on survival, local progression, and response rates.
RESULTS: Among 47 patients (12 EUS-RFA, 35 controls), median survival was 13.4 months in the EUS-RFA group versus 7.7 months for controls (hazard ratio, 0.50; P = .03). The survival probability at 12 months was 58% in the EUS-RFA group versus 22% for controls (P = .04). Adverse events were mild abdominal pain in 10% of RFA operations.
CONCLUSIONS: EUS-RFA as an adjunct for UPDAC ≤4 cm may improve survival with minimal side effects. (Trial registration: The study was a secondary exploratory analysis of a clinical trial registered at Thai Clinical Trials Registry (https://www.thaiclinicaltrials.org/show/TCTR20180706001) with clinical trial number 20180706001.).