Survival After Irreversible Electroporation in Unresectable Locally Advanced Pancreatic Cancer: A Meta-Analysis.

In 30 seconds

This systematic review and random-effects meta-analysis assessed survival after irreversible electroporation (IRE) in patients with unresectable, locally advanced pancreatic ductal adenocarcinoma. Thirty-one studies involving 1296 patients were included. Pooled overall survival after IRE was 16.3 months (95% CI: 14.2-18.4), and survival was longer among patients receiving IRE than among those who did not, with a mean difference of 6.97 months (95% CI: 0.79-13.15, P = 0.03). The authors judged the evidence to be of low-to-moderate certainty and called for randomized trials.

Key findings

• Pooled overall survival after IRE was 16.3 mo (95% CI: 14.2-18.4).
• Compared with patients who did not receive IRE, those treated with IRE had a mean survival difference of 6.97 mo (95% CI: 0.79-13.15, P = 0.03).
• Meta-regression found no significant association between survival and age, sex, tumor size or location, or pretreatment chemotherapy.

Why it matters

Unresectable locally advanced PDAC has limited treatment options, and these pooled findings suggest IRE may be associated with longer overall survival. However, the evidence is not definitive: the review included single-arm and comparative studies, and the authors characterize certainty as low to moderate. The results help frame the potential benefit while underscoring the need for randomized evaluation.

What to keep in mind

The meta-analysis included single-arm as well as comparative studies, so the pooled survival difference does not establish a causal benefit of IRE. The authors identify the evidence as low-to-moderate certainty.