Vall d'Hebron University Hospital has performed the first intraoperative radiofrequency in a locally advanced pancreatic adenocarcinoma of the State. This type of cancer in advanced stage is considered to be the worst prognosis among pancreatic tumors, with an average survival of 11 months. Dr. Ramón Charco, head of the Hepatobiliary and Pancreatic and Transplant Department and head of the Digestive Transplant group of the Vall d'Hebron Research Institute (VHIR), attended the press conference to present the surgery, Dr. Elizabeth Pando, of the Service of Hepatobiliopancreatic Surgery and Transplants and researcher of the Digestive Transplant group of the VHIR, Dr. Joaquim Balsells, clinical chief of Pancreatic Surgery and researcher of the Digestive Transplantation group of VHIR, and Mr. àngel Font, corporate director of the Research and Strategy Area of the "la Caixa" Banking Foundation.Pancreatic cancer is the third cause of death from cancer worldwide and it is estimated that in 2019 it will be the second cause of cancer death. As Dr. Ramón Charco explains, "adenocarcinomas of locally advanced pancreas are not operable due to the involvement of larger arteries and veins. And neither are treatments such as chemotherapy or immunotherapy effective, since adenocarcinomas are hidden in the stroma, which is a network of cells that protect and nourish the tumor cells. "Therefore, this type of tumor has such a poor prognosis because it is protected by the stroma, a network of connective tissue and cells that feeds the tumor cells and also serves as an impenetrable shield for chemotherapy or immunotherapy. "Therefore, the challenge is to develop new techniques to transfer this shield and reach the tumor," adds Dr. Charco.Currently, experts from the Academic Medical Center of the Netherlands are carrying out the only multicenter randomized study worldwide on the new technique, which consists of introducing a needle directly into the tumor and burn the tumor cells. Vall d'Hebron is the only center in Spain that participates in the study.As Dr. Elizabeth Pando points out, "the needle breaks the shield and allows us to apply temperatures of up to 80 degrees directly in the tumor zone. These high temperatures literally burn the tumor causing cell death. This process also facilitates the exposure of tumor components for immune cells to attack them. "Specialized equipment to avoid serious complicationsThe reason why Vall d'Hebron University Hospital has been the only one hospital of the State chosen to participate in the study because, "it is necessary a high specialization of the professionals who must carry out all the treatment. Vall d'Hebron has a high-level multidisciplinary team. The team of Dr. Teresa Macarulla of the Medical Oncology Service is responsible for the specific chemotherapy for this type of tumors. And the surgeons select and operate the patients to expose the pancreas and an expert interventional radiologist, Dr. Xavier Serres, insert the needle into the tumor area and perform the ablation," explains Dr. Joaquim Balsells. The equipment necessary for the intervention has been provided by the Olympus company for the entire study in Europe.Pancreatic adenocarcinomas are usually close to the duodenum or the mesenteric artery and vein. If the radiologist is not precise enough, the application of high temperatures in these areas would cause serious injuries. Therefore, adds Dr. Pando, "in this type of intervention a continuous flow enteral cooling system is used, which allows the introduction of cooling fluids that reach areas such as the duodenum to prevent them from overheating."Vall d'Hebron has already involved three patients using this pioneering surgery without any type of complication. The results of the study will be known in the year 2021. "If it is confirmed the effectivity of that therapy for locally advanced pancreatic adenocarcinoma, we will finally have a technique that improves the prognosis of this malignant tumor", concludes the Dr. Charco.