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.