Systematic review of novel ablative methods in locally advanced pancreatic cancer

Table 4 Studies of cryoablation in pancreatic ductal adenocarcinoma

Study	n	Patients	Study	Outcome	Complications
Patiutko et al[25] (non-English article)	30	Locally advanced PDAC	Combination of cryosurgery and radiation	Pain relief and improvement in performance status: 30/30	Not reported
Kovach et al[52]	9	Unresectable PDAC	Phase I study of intraoperative cryoablation under US guidance. Four had concurrent gastrojejunostomy	7/9 discharged with non-intravenous analgesia and 1/9 discharged with no analgesia	No complications reported
Li et al[53] (non-English article)	44	Unresectable PDAC	Intraoperative cryoablation under US guidance	Median overall survival: 14 mo	40.9% (18/44) had delayed gastric empting. 6.8% (3/44) had a bile and pancreatic leak
Wu et al[54] (non-English article)	15	Unresectable PDAC	Intraoperative cryoablation under US guidance	Median overall survival: 13.4 mo	1/15 patients developed a bile leak
Yi et al[55] (non-English article)	8	Unresectable PDAC	Intraoperative cryoablation under US guidance	Not reported	25% (2/8) developed delayed gastric emptying
Xu et al[26]	38	Locally advanced PDAC, 8 had liver metastases	Intraoperative or percutaneous cryoablation under US or CT guidance + (125) iodine seed implantation	Median overall survival: 12 mo. 19/38 (50.0%) survived more than 12 mo	Acute pancreatitis: 5/38 (one has severe pancreatitis)
Xu et al[56]	49	Locally advanced PDAC, 12 had liver metastases	Intraoperative or percutaneous cryoablation under US or CT guidance and (125) iodine seed implantation. Some patients also received regional celiac artery chemotherapy	Median survival: 16.2 mo. 26 patients (53.1%) survived more than 12 mo	Acute pancreatitis: 6/49 (one had severe pancreatitis)
Li et al[57]	68	Unresectable PDAC requiring palliative bypass	Retrospective case-series of intraoperative cryoablation under US guidance, followed by palliative bypass	Median overall survival: 30.4 mo (range 6-49 mo)	Postoperative morbidity: 42.9%. Delayed gastric emptying occurred in 35.7%
Xu et al[58]	59	Unresectable PDAC	Intraoperative or percutaneous cryotherapy	Median survival: 8.4 mo. Overall survival at 12 mo: 34.5%	Mild abdominal pain: 45/59 (76.3%) Major complications (bleeding, pancreatic leak): 3/59 (5%) 1/59 developed a tract metastasis
Niu et al[29]	36 (CT) 31 (CIT)	Metastatic PDAC	Intraoperative cryotherapy (CT) or cryoimmunotherapy (CIT) under US guidance	Median overall survival in CIT: 13 mo CT: 7 mo	Not reported

PDAC: Pancreatic ductal adenocarcinoma.