Survival After Irreversible Electroporation in Unresectable Locally Advanced Pancreatic Cancer: A Meta-analysis
In brief
Irreversible electroporation extends median survival by about seven months in unresectable pancreatic cancer
In a meta-analysis of 31 studies (1,296 patients), patients receiving irreversible electroporation lived a median 16.3 months, roughly seven months longer than those treated without it. Survival was unrelated to age, sex, tumor size or location, and was similar whether the procedure was surgical or percutaneous. The finding, based on low-to-moderate certainty evidence, underscores the need for randomized trials.
- Journal
- The Journal of surgical research (Q1)
- Published
- 15 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Shahab Hajibandeh, Mariam Hussain, Kholoud Abu Taha, Vaishnavi Sujathan, Louise M Finch, Shahin Hajibandeh, et al.
- PMID
- 42743900
- DOI
- 10.1016/j.jss.2026.08.030
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (top studies of the week, 20 September 2026): High-quality evidence in a top journal
- Picked for Gastrointestinal and Colorectal Surgery (top studies of the week, 20 September 2026): Meta‑analysis of irreversible electroporation for pancreatic cancer
- Picked for Bariatric and Metabolic Surgery (top studies of the week, 20 September 2026): High-quality evidence in a top journal
- Picked for Pediatric Surgery (top studies of the week, 20 September 2026): IRE for pancreatic cancer, adult oncology
Abstract
INTRODUCTION: To evaluate the overall survival (OS) time and predictors of survival in patients with unresectable locally advanced pancreatic ductal adenocarcinoma (PDAC) who were treated with irreversible electroporation (IRE). METHODS: According to PRISMA guidelines, a systematic review and random-effects meta-analysis (single-arm and comparison) with meta-regression was conducted. All studies reporting OS time after IRE in patients with unresectable locally advanced PDAC were included. RESULTS: Thirty-one studies including 1296 patients were included. The OS time after IRE was 16.3 mo (95% CI: 14.2-18.4); it was longer in patients who received IRE than in those who did not (mean difference: 6.97 mo, 95% CI: 0.79-13.15, P = 0.03). The OS time was not affected by age (coefficient: -0.088, P = 0.722), male sex (coefficient: -0.049, P = 0.314), tumor size (coefficient: -0.049, P = 0.710), tumors located in the head of pancreas (coefficient: -3.141, P = 0.696), tumors located in the body or tail of pancreas (coefficient: 2.498, P = 0.747), and pretreatment chemotherapy (coefficient: 3.378, P = 0.233). Subgroup analyses showed that OS time was not affected by surgical (18.1 mo, 95% CI: 13.4-22.9) or percutaneous (14.9 mo, 95% CI: 12.2-17.6) approaches used or when IRE was combined with immunotherapy (20.3 mo, 95% CI: 5.4-35.2) or chemotherapy (18.5 mo, 95% CI: 15.5-21.4). CONCLUSIONS: IRE may improve OS time in patients with unresectable locally advanced PDAC (low-to-moderate certainty). The results of current study support the rationale for conducting future randomized trials in this setting and provide a robust basis for hypothesis generation and power analysis.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.