冷冻消融治疗局部晚期胰腺癌的安全性和有效性

Pancreatic cancer has an extremely poor prognosis. Although surgery is the first-line treatment for pancreatic cancer, its role is ultimately limited because patients often present too late for resection. Thus, multidisciplinary treatment approaches are needed. In particular, chemotherapy, targeted therapy, and immunotherapy can be ineffective for locally advanced pancreatic cancer (LAPC) because of its resistance to these modalities, but cryoablation has shown significant promise for treating this entity and prolonging survival. AIM: To investigate the safety and efficacy of cryoablation for LAPC.

Clinical and laboratory data, including surgical procedure, postoperative complications, immunobiochemical markers ( e.g. , carbohydrate antigen 19-9), and follow-up visits, of 24 LAPC patients treated with cryoablation at the department of hepatobiliary and pancreatic surgery of our hospital from January 2023 to December 2024 were retrospectively analyzed.

Surgery was smooth in all patients, with no perioperative deaths. Postoperative pancreatic fistulas occurred in 18 patients (75.0%), including biochemical leak in 14 cases and grade B (fistula) in 4 cases. Three patients (12.5%) had delayed gastric emptying. The carbohydrate antigen 19-9 level remained low on postoperative day 30 ( P < 0.05). Immune markers (natural killer cells and tumor necrosis factor-alpha) significantly increased on days 7 and 30 ( P < 0.01 or P < 0.05), whereas cluster of differentiation CD4+ T cells levels on day 30 significantly differed from baseline. Day 30 pain scores were significantly lower than preoperative ones ( P < 0.01). Tumor volume was reduced on postoperative computed tomography. Survival was prolonged. The overall survival time of LAPC patients treated with cryoablation was 16.8 months.

Cryoablation can directly inactivate LAPC and boost immunity, thus delaying tumor progression, alleviating pain, improving quality of life, and prolonging survivals. Therefore, it is a safe and effective treatment option for LAPC.