Interventional management of unresectable pancreatic cancer using transarterial chemoembolization and microwave ablation: a single-center evaluation over 12 years

The aim of this study is to evaluate the safety and clinical outcomes of combined transarterial chemoembolization (TACE) and microwave ablation (MWA) as well as TACE monotherapy in patients with unresectable pancreatic cancer. Between 2010 and 2023, 150 patients with unresectable locally advanced pancreatic cancer were included in this retrospective single-center study and treated with either combined TACE and MWA (Group A, n = 67) or TACE alone (Group B, n = 83). In Group A, 23/67 (34.3%) patients presented with metastatic disease and in Group B 45/83 (54.2%) patients had metastatic disease. A total of 222 TACE procedures and 71 MWA procedures were performed in Group A, while 250 TACE procedures were performed in Group B. Follow-up was performed using contrast-enhanced cross-sectional imaging and clinical evaluation. Tumor response and overall survival were analyzed. The mean tumor diameter was 3.4 ± 0.9 cm in Group A and 4.9 ± 1.3 cm in Group B. No major complications occurred in either treatment group. Minor hemorrhage following MWA was observed in 4/71 ablations (5.6%) without further clinical consequence. In Group A, follow-up imaging was available for 47/67 patients, with local tumor progression observed in 5/47 patients (10.6%). The 1-year overall survival rate was 69.4%, with a median overall survival time of 14.6 months (95% CI 12.6–16.7 months). In Group B, follow-up imaging was available for all 83 patients, with local tumor progression observed in 8/83 patients (9.6%). The 1-year overall survival rate was 43.6%, with a median overall survival time of 9.0 months (95% CI 3.3–14.7 months). TACE and MWA were safe locoregional treatments for patients with unresectable pancreatic cancer. Both treatment protocols, including the combination of TACE with MWA and TACE as monotherapy, were effective and showed promising results.