Introduction: Radiofrequency ablation has been demonstrated to be effective in the treatment of unresectable hepatic tumours and promising results have been obtained in other cancers. Small series and case reports suggest that this technique is feasible and safe in selected patients with pancreatic cancer. The aim of this study was to assess the safety of radiofrequency ablation in patients with non-metastatic, locally advanced pancreatic cancer.
Methods: Full ethical approval was obtained from the Local Research Ethics Committee. Pre-operative consent was obtained from 8 patients with non-metastatic pancreatic tumours staged as being of borderline resectability. Five patients (3 female, 2 male) with tumours deemed inoperable after full laparotomy were recruited. Radiofrequency ablation was performed using the Cool-tip ablation system with a single, cooled electrode. Accurate needle placement was confirmed by intra-operative ultrasound and the target temperature controlled by a thermosensor at the tip of the needle was 90OC.
Results: Three of the five patients developed life-threatening post-ablation complications. One patient died as a result of a post-operative biliary leak, severe sepsis and multi-organ failure. Significant gastrointestinal haemorrhage occurred in two cases requiring angiographic embolisation. Given these initial complications, the study was terminated after discussion with the local ethics committee. Overall median survival was 6.6 months (range 0.4 -14).
Conclusion: The results of this pilot study suggest that radiofrequency ablation for locally advanced pancreatic cancer is associated with unacceptable, life-threatening post-ablation complications.