Analysis of the Safety and Efficacy of Cryoablation in Patients with Locally Advanced Pancreatic Cancer.

BACKGROUND

Cryoablation is emerging as a potential treatment option for locally advanced pancreatic cancer (LAPC). The aim of this study was to retrospectively evaluate the safety and efficacy of cryoablation in patients with LAPC. The study has been prospectively registered in the Chinese Clinical Trial Registry (ID: ChiCTR2300068376).

PATIENTS AND

METHODS

Adult patients with LAPC were stratified based on the treatment modality (cryoablation versus systemic therapy). The cryoablation was performed using a single cryoprobe under ultrasound guidance. The Kaplan-Meier method was utilized to evaluate and compare overall survival (OS) among the groups. Cox proportional hazards regression analysis was employed to identify independent predictors of overall survival.

RESULTS

Of 186 enrolled patients with LAPC between August 2022 and December 2024, 142 were in the cryoablation group and 44 in the systemic therapy alone group. The median OS was 17.8 months with systemic therapy alone and 18.7 months with cryoablation alone. Combined cryoablation and systemic therapy yielded a median OS of 22.1 months. Among patients receiving cryoablation combined with chemotherapy median OS was 19.8 months, and for combination systemic therapy group (chemotherapy + immunotherapy ± targeted therapy), it was 25.4 months. Multivariate analysis identified age, tumor location, treatment type, and jaundice as independent OS predictors. Additionally, nearly all patients experienced marked pain relief after cryoablation treatment.

CONCLUSIONS

When combined with systemic therapy, cryoablation has a more significant survival advantage than systemic therapy alone. However, due to the heterogeneity of the cohort and potential immortal time bias, these survival outcomes should be interpreted with caution. Additionally, cryoablation offers effective benefits for relieving cancer pain and preserving functional quality of life in patients with LAPC.