Ultrasound–Guided Percutaneous Laser Ablation: A New Treatment Option for Pancreatic Cancer

Abstract Background and aim: Most patients with pancreatic cancer (PC) suffer from an unresectable tumor at the time of diagnosis with limited treatment effectiveness. The aim of this study is to investigate the feasibility and safety of percutaneous laser ablation (LA) for locally advanced and metastatic PC. Methods Between September 2016 and November 2019, ten patients (mean age, 64.2 ± 6.7 years; range, 62–68 years) with histologically proved PC were prospectively included to undergo ultrasound-guided percutaneous LA. Treatment effect including safety, pain perception and survival were evaluated. Results Three patients were with locally advanced PC (stage III) and seven with metastases (stage IV). All patients underwent LA in one session. The mean largest diameter of tumor was 5.5 ± 0.9 cm (range, 4.2–9.4 cm). Ablation power of all patients was 5 W and the mean ablation energy was 8.1 ± 2.6 KJ (range, 4.4–12KJ). Mean ablation volume was 16.1 ± 3.8 ml (range, 13.0 – 22.1 ml), which reached 89.1 ± 7.4% (range, 80.2 – 98.0 %) of tumor volume. After a median follow-up period of 10.4 months (range, 6.2–18.4 months), the median survival from diagnosis was 11.5 months. Four stage IV patients died during 6.5–12.5 months after LA because of one hepatic encephalopathy and three tumor progression. No major complications occurred. Pain symptom achieved significant remission (P < 0.001) and patients experienced ameliorative physical function after LA. Conclusions Percutaneous LA for unresectable PC is generally well tolerated. Preliminary results are encouraging with tumor size reducing and physical function significant improvement. The technique provides a new minimally invasive therapy modality for PC.