Safety and efficacy of cryoablation in treating locally advanced pancreatic cancer

doi:10.4251/wjgo.v17.i12.113387

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Dec 15, 2025; 17(12): 113387
Published online Dec 15, 2025. doi: 10.4251/wjgo.v17.i12.113387

Safety and efficacy of cryoablation in treating locally advanced pancreatic cancer

Li-Min Kang, Xiao-Long He, Li Lang, A-Yong Wang, Xian Wang, Yu-Hao Liu, Ying-Hong Zhao, Lei Xu, Fa-Kun Yu, Fu-Wei Zhang

Li-Min Kang, A-Yong Wang, Ying-Hong Zhao, Lei Xu, Fa-Kun Yu, Fu-Wei Zhang, Department of Hepatobiliary and Pancreatic Surgery, Puer People’s Hospital, Puer 665000, Yunnan Province, China

Xiao-Long He, Clinical Medicine College, School of Medicine, Kunming University of Science and Technology, Kunming 650000, Yunnan Province, China

Li Lang, Department of Outpatient, Puer People’s Hospital, Puer 665000, Yunnan Province, China

Xian Wang, Yu-Hao Liu, Department of Cancer Center, Puer People’s Hospital, Puer 665000, Yunnan Province, China

Co-first authors: Li-Min Kang and Xiao-Long He.

Author contributions: Kang LM, Wang AY, Zhao YH, Xu L, Yu FK, and Zhang FW performed surgeries; Kang LM, Xu L, Yu FK, Lang L, Zhang FW, Wang X, and Liu YH collected the clinical and tumor data; Kang LM and He XL analyzed the data, wrote the paper, and contributed equally as co-first authors. All the authors have read and approved the final version.

Institutional review board statement: The study was received and approval by the Institutional review board of Puer People’s Hospital, No. 2024-001-05. All procedures were carried out in accordance with the Helsinki Declaration. All methods were carried out in accordance with relevant guidelines and regulations in the declaration.

Informed consent statement: Due to the retrospective nature of the study, informed consent was waived.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: All data generated or analyzed during this study are included in this published article. Further information can be obtained from the corresponding author on reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Li-Min Kang, MD, PhD, Professor, Department of Hepatobiliary and Pancreatic Surgery, Puer People’s Hospital, No. 44 Zhenxing Street, Puer 665000, Yunnan Province, China. kanglimin2010@163.com

Received: August 25, 2025
Revised: September 28, 2025
Accepted: October 31, 2025
Published online: December 15, 2025
Processing time: 109 Days and 22.4 Hours

Abstract

BACKGROUND

Pancreatic cancer has an extremely poor prognosis. Although surgery is the first-line treatment for pancreatic cancer, its role is ultimately limited because patients often present too late for resection. Thus, multidisciplinary treatment approaches are needed. In particular, chemotherapy, targeted therapy, and immunotherapy can be ineffective for locally advanced pancreatic cancer (LAPC) because of its resistance to these modalities, but cryoablation has shown significant promise for treating this entity and prolonging survival.

AIM

To investigate the safety and efficacy of cryoablation for LAPC.

METHODS

Clinical and laboratory data, including surgical procedure, postoperative complications, immunobiochemical markers (e.g., carbohydrate antigen 19-9), and follow-up visits, of 24 LAPC patients treated with cryoablation at the department of hepatobiliary and pancreatic surgery of our hospital from January 2023 to December 2024 were retrospectively analyzed.

RESULTS

Surgery was smooth in all patients, with no perioperative deaths. Postoperative pancreatic fistulas occurred in 18 patients (75.0%), including biochemical leak in 14 cases and grade B (fistula) in 4 cases. Three patients (12.5%) had delayed gastric emptying. The carbohydrate antigen 19-9 level remained low on postoperative day 30 (P < 0.05). Immune markers (natural killer cells and tumor necrosis factor-alpha) significantly increased on days 7 and 30 (P < 0.01 or P < 0.05), whereas cluster of differentiation CD4+ T cells levels on day 30 significantly differed from baseline. Day 30 pain scores were significantly lower than preoperative ones (P < 0.01). Tumor volume was reduced on postoperative computed tomography. Survival was prolonged. The overall survival time of LAPC patients treated with cryoablation was 16.8 months.

CONCLUSION

Cryoablation can directly inactivate LAPC and boost immunity, thus delaying tumor progression, alleviating pain, improving quality of life, and prolonging survivals. Therefore, it is a safe and effective treatment option for LAPC.

Keywords: Pancreatic cancer; Cryoablation; Ultrasound guidance; Complication; Postoperative follow-up

Core Tip: Pancreatic cancer has an extremely poor prognosis. In particular, chemotherapy, targeted therapy, and immunotherapy may be ineffective for locally advanced pancreatic cancer (LAPC) because of its resistance to these modalities. In this retrospective study, 24 LAPC patients were treated with cryoablation at our hospital. The outcomes show that cryoablation can directly inactivate LAPC and boost immunity, thus delaying tumor progression, alleviating pain, improving quality of life, and prolonging survivals. Therefore, it is a safe and effective treatment option for LAPC that deserves wider adoption in clinical settings.