Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy
Abstract Objective Endoscopic ultrasound (US)‐guided radiofrequency ablation (RFA) has been investigated for pancreatic ductal adenocarcinoma (PDAC) but studies are limited and heterogeneous. Computed tomography (CT) scan features may predict RFA response after chemotherapy but their role is unexplo...
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Wiley
2023-04-01
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| Online Access: | https://doi.org/10.1002/deo2.152 |
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| author | Gemma Rossi Maria Chiara Petrone Marco Schiavo Lena Luca Albarello Diego Palumbo Sabrina Gloria Giulia Testoni Livia Archibugi Matteo Tacelli Piera Zaccari Giuseppe Vanella Laura Apadula Stefano Crippa Giulio Belfiori Michele Reni Massimo Falconi Claudio Doglioni Francesco De Cobelli Andrew J Healey Gabriele Capurso Paolo Giorgio Arcidiacono |
| author_facet | Gemma Rossi Maria Chiara Petrone Marco Schiavo Lena Luca Albarello Diego Palumbo Sabrina Gloria Giulia Testoni Livia Archibugi Matteo Tacelli Piera Zaccari Giuseppe Vanella Laura Apadula Stefano Crippa Giulio Belfiori Michele Reni Massimo Falconi Claudio Doglioni Francesco De Cobelli Andrew J Healey Gabriele Capurso Paolo Giorgio Arcidiacono |
| author_sort | Gemma Rossi |
| collection | DOAJ |
| description | Abstract Objective Endoscopic ultrasound (US)‐guided radiofrequency ablation (RFA) has been investigated for pancreatic ductal adenocarcinoma (PDAC) but studies are limited and heterogeneous. Computed tomography (CT) scan features may predict RFA response after chemotherapy but their role is unexplored. The primary aim was to investigate the efficacy of ex‐vivo application of a dedicated RFA system at three power on surgically resected PDAC in patients who underwent neoadjuvant chemotherapy. The secondary aim was to explore the association between pre‐treatment CT‐based quantitative features and RFA response. Methods Fifteen ex‐vivo PDAC samples were treated by RFA under US control at three power groups (10, 30, and 50 W). Short axis necrosis diameter was measured by two expert blinded pathologists as the primary outcome. Two radiologists independently reviewed preoperative CT images. Results Eighty percent of specimens showed coagulative necrosis consisting of few millimeters: 5.7 ± 3.9 mm at 10 W, 3.7 ± 2.2 mm at 30 W, and 3.5 ± 2.4 mm at 50 W (p = 0.3), without a significant correlation between power setting and mean necrosis short axis (rho = –0.28; p = 0.30). Good agreement was seen between pathologists (k = 0.76; 95% confidence interval 0.55–0.98). Logistic regression analysis did not show associations between CT features and RFA response. Conclusions RFA causes histologically evident damage with coagulative necrosis of a few millimeters in 80% of ex‐vivo PDAC samples after chemotherapy and no clinical or pre‐operative CT features can predict efficacy. Power settings do not correlate with the histological ablation area. These results are of relevance when employing RFA in vivo and planning clinical trials on its role in PDAC patients. |
| format | Article |
| id | doaj-art-81ca3358e5a342b8bac0372a67c0f3f8 |
| institution | Kabale University |
| issn | 2692-4609 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Wiley |
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| series | DEN Open |
| spelling | doaj-art-81ca3358e5a342b8bac0372a67c0f3f82025-08-20T03:49:41ZengWileyDEN Open2692-46092023-04-0131n/an/a10.1002/deo2.152Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapyGemma Rossi0Maria Chiara Petrone1Marco Schiavo Lena2Luca Albarello3Diego Palumbo4Sabrina Gloria Giulia Testoni5Livia Archibugi6Matteo Tacelli7Piera Zaccari8Giuseppe Vanella9Laura Apadula10Stefano Crippa11Giulio Belfiori12Michele Reni13Massimo Falconi14Claudio Doglioni15Francesco De Cobelli16Andrew J Healey17Gabriele Capurso18Paolo Giorgio Arcidiacono19Division of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pathology, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pathology, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDepartment of Radiology Pancreas Translational and Clinical Research Center San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Oncology, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreatic Surgery, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pathology, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDepartment of Radiology Pancreas Translational and Clinical Research Center San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDepartment of Clinical Surgery Royal Infirmary of Edinburgh, University of Edinburgh Edinburgh UKDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyDivision of Pancreato‐Biliary Endoscopy and Endosonography, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University Milan ItalyAbstract Objective Endoscopic ultrasound (US)‐guided radiofrequency ablation (RFA) has been investigated for pancreatic ductal adenocarcinoma (PDAC) but studies are limited and heterogeneous. Computed tomography (CT) scan features may predict RFA response after chemotherapy but their role is unexplored. The primary aim was to investigate the efficacy of ex‐vivo application of a dedicated RFA system at three power on surgically resected PDAC in patients who underwent neoadjuvant chemotherapy. The secondary aim was to explore the association between pre‐treatment CT‐based quantitative features and RFA response. Methods Fifteen ex‐vivo PDAC samples were treated by RFA under US control at three power groups (10, 30, and 50 W). Short axis necrosis diameter was measured by two expert blinded pathologists as the primary outcome. Two radiologists independently reviewed preoperative CT images. Results Eighty percent of specimens showed coagulative necrosis consisting of few millimeters: 5.7 ± 3.9 mm at 10 W, 3.7 ± 2.2 mm at 30 W, and 3.5 ± 2.4 mm at 50 W (p = 0.3), without a significant correlation between power setting and mean necrosis short axis (rho = –0.28; p = 0.30). Good agreement was seen between pathologists (k = 0.76; 95% confidence interval 0.55–0.98). Logistic regression analysis did not show associations between CT features and RFA response. Conclusions RFA causes histologically evident damage with coagulative necrosis of a few millimeters in 80% of ex‐vivo PDAC samples after chemotherapy and no clinical or pre‐operative CT features can predict efficacy. Power settings do not correlate with the histological ablation area. These results are of relevance when employing RFA in vivo and planning clinical trials on its role in PDAC patients.https://doi.org/10.1002/deo2.152endoscopic ultrasoundex‐vivoneoadjuvant chemotherapypancreatic adenocarcinomaradiofrequency ablation |
| spellingShingle | Gemma Rossi Maria Chiara Petrone Marco Schiavo Lena Luca Albarello Diego Palumbo Sabrina Gloria Giulia Testoni Livia Archibugi Matteo Tacelli Piera Zaccari Giuseppe Vanella Laura Apadula Stefano Crippa Giulio Belfiori Michele Reni Massimo Falconi Claudio Doglioni Francesco De Cobelli Andrew J Healey Gabriele Capurso Paolo Giorgio Arcidiacono Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy DEN Open endoscopic ultrasound ex‐vivo neoadjuvant chemotherapy pancreatic adenocarcinoma radiofrequency ablation |
| title | Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy |
| title_full | Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy |
| title_fullStr | Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy |
| title_full_unstemmed | Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy |
| title_short | Ex‐vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy |
| title_sort | ex vivo investigation of radiofrequency ablation in pancreatic adenocarcinoma after neoadjuvant chemotherapy |
| topic | endoscopic ultrasound ex‐vivo neoadjuvant chemotherapy pancreatic adenocarcinoma radiofrequency ablation |
| url | https://doi.org/10.1002/deo2.152 |
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