Research Article

Irreversible Electroporation in Patients with Pancreatic Cancer: How Important Is the New Weapon?

Table 1

Summary of the studies included in the systematic review.

AuthorStudy periodDesign styleCountryTumor sizeTreatment methodsPatients (number of benign thyroid nodules)Male/femaleAge (years)Follow-up interval (months)ComplicationImaging methodsPrognosis

Paiella et al. 20152011.6–2011.12Prospective cohortItaly30 mmUS-guided percutaneous IRE10 (10)5/5667.61, abscesses; 5, abdominal and back pain; 1, portal vein thrombosis; 1, peripheral oedema; 1, infectionCT3, progression disease; 1, pulmonary metastasis; 2, liver metastasis

Martin II et al. 20152010.7–2014.10Prospective cohortUnited States1–7 cmCT-guided percutaneous IRE200101/9962 (27–88)29 months37% complicationsCT58, recurrence; overall progression-free survival: 12.4 (4.4–38.9); time to distant progression: 16.8 (1.3–55)

Belfiore et al. 20152013.4–2014.6Prospective cohortItaly93 (39–170) cm3CT-guided percutaneous IRE20 (20)10/1069 (55–82)8.55 (3–14)1 ascites;CeCT18, PR; 2, died

Yan et al. 20162015.7–2016.6Retrospective cohortChina4.2 (2.8–4.9) cmOpen IRE with/without surgery25 (25)19/658 (49–80)33, pancreatic fistula; 1, acute pancreatitis; 1, delayed gastric emptying; 1, gastrointestinal hemorrhageCT/MRI9, PD; 7, SD

Michail et al. 20162014.4–2015.3Retrospective cohortUnited Kingdom12.3 ± 9.3 mmCT-guided percutaneous IRE3 (3)NA53 ± 20.815 ± 3.61 mild pancreatitisCT3, not recurrence

Månsson et al. 2016NARetrospective cohortSweden27 ± 15.5 cm3US-guided percutaneous IRE2412/1263.1 ± 8.617.95, infection; 2, pancreatitis; 1, thrombosis of the superior mesenteric veinNA10, recurrence; 13, metastases; mean OS: 17.9 months

Kluger et al. 2016 2012.10–2015.1Prospective cohortUnited States3.0 (1.7–5.0) cmNA50 (53)31/2266.5 (60.2–72.0)8.691, duodenal ulceration/perforationNA31, recurrence; mean OS: 7.71–12.03 months

Lambert et al. 20162012.6–2014.12Prospective cohortCzech Republic38.2 ± 11.5 mmNA2110/1168.2 ± 8.410.21, liver abscesses; 1, biliary peritonitis; 1, cholangitis; 1, pancreatic fistula; 1, bleeding; 1, peripancreatic abscess; 1, fistula and abscess in the abdominal wallCTMedian survival afer IRE was 10.2 months

Vroomen et al. 20162014.1–2015.6Prospective cohortNetherlands19 cm3CT-guided percutaneous IRE25 (25)12/1361 (41–78)6 (3–17)1, pancreatitis; 1, duodenal wall ulcer; 3, biliary obstruction; 1, cholangitisCeCT/CeMRI5, local recurrence

Niu et al. 20162015.7.2–2015.9.30Prospective cohortChina4.3 ± 1.9 (2.4–7.4) cm7 CT-guided percutaneous IRE; 5 open IRE12 (12)9/355.5 ± 13.8 (49–75)1No major complicationsCeCT1, CR; 9, PR; 2, SD

Scheffer et al. 20162014.1–2015.6Prospective cohortNetherlands4.0 (3.3–5.0) cmCT-guided percutaneous IRE25 (25)12/1361 (41–78)12 (7–16)1, pancreatitis; 1, hematemesis; 3, biliary obstruction; 1, cholangitisCeCTMedian event-free survival from IRE: 8 months; median time to local progression from IRE: 12 months

Narayanan et al. 20172010.11.1–2015.8.31Retrospective cohortUnited States3.2 ± 1.3 cmCT-guided percutaneous IRE50 (50)27/2362.5 (46–91)2719, abdominal pain; 6, pancreatitis; 3, thrombosis; 1, sepsis; 1, gastric leak; 3, nausea; 4, emesis; 3, hematoma; 1, fever; 1, constipation; 1, urinary discomfort; 1, back pain; 1, malaiseCT3, progression; median OS was 27.0 months

Zhang et al. 20172015.7–2017Prospective cohortChina3.5 (2.0–6.7) cmCT/US-guided percutaneous IRE21 (21)NANA11, hypoglycemia, 1, hypokalemia, 1, chest tightnessCT2, CR; 9, PR; 3, SD

Lin et al. 20172016.3–2016.12Prospective cohortChina4.51 ± 1.13 cmCT/US-guided percutaneous IRE20 (20)11/95327, fever; 4, fatigue; 3, chest distress; 2, chills; 2, nausea; 1, hypoglycemiaCT/US3, CR; 9, PR; 4, SD; 3, PD

Belfiore et al. 20172013–2016Retrospective cohortItaly94 cm3CT-guided percutaneous IRE29 (29)16/1368.529No major complicationsCeCT22, died; the median OS: 14 months

NA: not available; CR: complete response; PR: partial response; OS: overall survival; IRE: irreversible electroporation; US: ultrasonography; CT: computed tomography; CeCT: contrast-enhanced computed tomography.