Endoscopy 2019; 51(04): S58-S59
DOI: 10.1055/s-0039-1681342
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: EUS therapeutic pancreas South Hall 2B
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ULTRASOUND-GUIDED HYBRIDTHERM ABLATION (EUS-HTP) IN PATIENTS (PTS) WITH LOCALLY ADVANCED (LA) PANCREATIC DUCTAL ADENOCARCINOMA (PDAC): A CASE-CONTROL COMPARATIVE SURVIVAL ANALYSIS

S Testoni
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
MC Petrone
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
W Linzenbold
2   Erbe Elektromedizin GmbH, Tubingen, Germany
,
M Enderle
2   Erbe Elektromedizin GmbH, Tubingen, Germany
,
G Capurso
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
G Rossi
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
L Archibugi
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
M Traini
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
,
M Reni
3   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Medical Oncology, Pancreas Translational and Clinical Research Center, Milan, Italy
,
M Falconi
4   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, Milan, Italy
,
PG Arcidiacono
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Aim of the study was to assess the survival outcomes of pts with LA PDAC treated with chemotherapy ± radiotherapy (CT ± RT) plus endosonography-guided HybridTherm ablation (EUS-HTP) vs. those receiving only CT ± RT.

Methods:

Pts with LA PDAC, with local disease progression (PD) after first-line CT ± RT or unfit for CT (cases), prospectively treated by HTP (2010 – 2016), were retrospectively compared to similar pts not treated by HTP (controls). HTP (ERBE, Germany) is a bipolar probe combining radiofrequency with cryogenic cooling. Parametric/non-parametric tests and Log-rank Mantel-Cox tests for group differences were used (p ≤0.05 as significant).

Results:

19/19 cases/controls were included. Five cases did not receive CT ± RT before EUS-HTP due to concomitant comorbidity. The 2 groups had no difference regarding features at diagnosis (sex, age, lesion site and size, serum CA19.9, CT scheme and duration) and after first-line treatment (lesion size, serum Ca 19 – 9, progression-free survival time). EUS-HTP was performed ≥2 times in 7 cases. OS in cases vs. controls from diagnosis, first-line CT ± RT onset and local PD was similar (p = 0.22; p = 0.82; p = 0.54), as well as in the group of pts treated with further CT ± RT (p = 0.12; p = 0.68; p = 0.94). OS was significantly longer from local PD in cases compared to controls who did not undergo second-line CT ± RT (p = 0.05). OS in cases from EUS-HTP was 6 months, with no difference between pts treated with HTP only and those receiving concomitant CT ± RT (p = 0.18), and OS significantly longer in pts treated with ≥2 sessions vs. 1 session (p = 0.007).

Conclusions:

In pts with LA PDAC and local PD after first-line CT ± RT and unfit for a second-line treatment, EUS-HTP may obtain longer OS compared to palliative care. The increase of OS in pts treated by ≥2 EUS-HTP may suggest that repeated sessions can achieve a better disease control. A randomized controlled study comparing EUS-HTP plus CT ± RT vs. CT ± RT is ongoing and will better assess EUS-HTP efficacy.