Intraoperative electrochemotherapy in locally advanced pancreatic cancer: indications, techniques and results - a single‑center experience

Background Locally advanced pancreatic cancer (LAPC) is usually treated with chemoradiotherapy with poor results. The aim of the study was to assess whether intraoperative electrochemotherapy could be proposed as additional therapy in treat- ing LAPC. Methods Observational study of patients affected by LAPC who underwent intraoperative electrochemotherapy (ECT) after chemoradiotherapy. Data at diagnosis, at restaging and short and long-term outcomes, including assessment of quality of life, were collected for each patient. Results Five patients underwent ECT: in four cases, the tumours were located in the head and, in one, in the body of the pancreas. Preoperative chemotherapy consisted mainly of six cycles of modified Folfirinox. At restaging, the serum value of carbohydrate antigen (Ca 19–9) and tumour size were reduced; however, the vascular involvement did not change. No down- staging was recorded. The ECT procedure was performed using at least four needles with a mean duration time of 27 min (range 15–40). No postoperative mortality or major complications were reported. The mean length of stay (LOS) was 8 days (range 5–14). Four patients were alive and well at the end of the study, while one patient died from disease progression. The mean follow-up was 20.8 months (range 9–34) from diagnosis and 9.4 months (range 2–19) from ECT. The quality of life was good and there was improvement in pain/discomfort. Conclusions Electrochemotherapy could be proposed as a simple, feasible and safe palliative additional treatment in LAPC without progression after chemoradiotherapy. It seems to allow a good quality of life and pain improvement.