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World J Gastrointest Oncol. Feb 15, 2015; 7(2): 6-11
Published online Feb 15, 2015. doi: 10.4251/wjgo.v7.i2.6
Radiofrequency ablation of pancreatic ductal adenocarcinoma: The past, the present and the future
Garvi J Pandya, Vishal G Shelat
Garvi J Pandya, Medicine, Ministry of Health Holdings Pte Ltd, Singapore 308433, Singapore
Vishal G Shelat, Division of Hepato-pancreatico-biliary Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Pandya GJ and Shelat VG contributed equally to this work, generated the figures and wrote the manuscript.
Conflict-of-interest: None to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Vishal G Shelat, FRCS, FICS, Consultant Surgeon, Division of Hepato-pancreatico-biliary Surgery, Tan Tock Seng Hospital, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore. vgshelat@rediffmail.com
Telephone: +65-63577807 Fax: +65-63577809
Received: October 4, 2014
Peer-review started: October 5, 2014
First decision: November 3, 2014
Revised: November 10, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: February 15, 2015
Processing time: 119 Days and 7.4 Hours
Abstract

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers with a grim overall 5-year survival rate of 5%. Advances in surgical techniques, critical care, molecular diagnosis, diagnostic imaging, endosonology and adjuvant therapy have improved outcomes; but still more needs to be achieved. There is an urgent need to discover new avenues that may impact survival. Radiofrequency ablation (RFA) has attracted attention as an adjunctive treatment in PDAC. A review of English literature in PubMed was done using the MESH terms for PDAC and RFA. All the articles were reviewed and core information was tabulated for reference. After a comprehensive review of all articles the data was evaluated to discover the role of RFA in PDAC management. Indications, contraindications, feasibility, success rate, safety, complications and impact on survival were reviewed and are discussed further. RFA appears to be an attractive option for non-metastatic locally advanced PDAC. RFA is feasible but has a significant morbidity. At the present time the integration of RFA into the management of pancreatic ductal adenocarcinoma is evolving. It should be considered as having a complimentary role to current standard therapy in the multimodal management care model. It is likely that indications and patient selection for pancreatic RFA will expand.

Keywords: Pancreatic cancer; Radiofrequency ablation

Core tip: Radiofrequency ablation of pancreatic cancer is rapidly emerging as an attractive adjunct in locally advanced inoperable disease and is a part of modern multimodal hepatobiliary teams. Due to technological advances, refinements in thermokinetic principles and ongoing advances in medicinal oncology; it is likely that the role of radiofrequency in management of pancreatic cancer is going to increase in future. In this article we summarize the current evidence of application of radiofrequency ablation in pancreatic cancer.