Echoendoscopic ethanol ablation of tumor combined with celiac plexus neurolysis in patients with pancreatic adenocarcinoma

Guido Costamagna, Alberto Leonardo Larghi, Antonio Facciorusso, Marianna Di Maso, Gaetano Serviddio, Nicola Muscatiello

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

BACKGROUND AND AIM: Endoscopic ultrasonography guided-celiac plexus neurolysis relieves pain in pancreatic cancer patients but with often suboptimal and transient results. The study aims to compare the efficacy and safety of endoscopic ultrasound-guided tumor ethanol ablation combined with celiac plexus neurolysis with respect to celiac plexus neurolysis alone for pain management in pancreatic cancer patients. METHODS: Among 123 unresectable pancreatic cancer patients referred to our Institution between 2006 and 2014, 58 treated with endoscopic ultrasound-guided celiac plexus neurolysis (group 1) and 65 with the combined approach (group 2) were compared. Logistic regression models were applied to identify predictors of pain relief. RESULTS: The two groups presented similar baseline clinical and tumoral parameters. Pre-procedural visual analogue scale score was 7 in both groups (p = 0.8) and tumor max diameter was 38 mm (range 25-59) in group 1 and 43 mm (22-59) in group 2 (p = 0.4). The combined treatment increased pain relief and complete pain response rate (p = 0.005 and 0.003, respectively). Median duration of pain relief was 10 (7-14) and 18 (13-20) weeks in the two groups, respectively (p = 0.004). At multivariate regression, initial visual analogue scale score and endoscopic technique adopted resulted significantly associated to pain relief. No severe treatment-related adverse events were reported. Median overall survival was 6.5 months (5.1-8.6) in group 1 and 8.3 months (6-11.4) in group 2 (p = 0.05). CONCLUSIONS: Endoscopic ultrasound-guided tumor ablation combined with celiac plexus neurolysis appears to be superior to celiac plexus neurolysis alone in terms of pain control and overall survival
Original languageEnglish
Pages (from-to)N/A-N/A
JournalJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
DOIs
Publication statusPublished - 2016

Keywords

  • CPN
  • EUS
  • Pancreas cancer
  • ethanol injection

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