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Background: Pancreatic adenocarcinoma remains a challenging malignancy with a poor prognosis. Radiofrequency ablation (RFA) has emerged as a potential treatment for unresectable pancreatic adenocarcinoma (UPAC) aimed at improving survival and quality of life. This meta-analysis and systematic review evaluates the outcomes of RFA in UPAC. Methods: A comprehensive search was conducted in MEDLINE, Embase, Scopus, and Cochrane Central databases from inception to October 2023. Studies included patients over 18 years with UAPC undergoing RFA. Survival rates and complication rates were assessed as primary outcomes. Data were pooled using random-effects models, and heterogeneity was assessed with I2 statistics. ROBINS-I tool was used for quality assessment. Results: Nine studies encompassing 265 patients met the inclusion criteria. The mean age was 64.5 years, with 42.5% female participants. Survival analysis showed that at 30 days post-RFA, the mortality rate was 3.3%. At 6 months, the mortality rate was 20.9%, increasing to 50.4% at 12 months. At 24 months, the mortality rate was 61.9%. The pooled mean survival period at 12 and 24 months was 9.18 months and 14.26 months, respectively. Overall, 78.4% of patients died during the follow-up period, with an overall mean survival period of 12.27 months. The most common were intra-abdominal (10.1%), pancreatic (9.8%), and hepatobiliary (6.7%) complications. Conclusions: RFA shows potential in the management of unresectable pancreatic adenocarcinoma, with a manageable safety profile. However, the high heterogeneity and risk of bias in available studies highlight the need for well-designed randomized controlled trials to confirm these findings and establish standardized protocols. [ABSTRACT FROM AUTHOR]

Despite the growing literature on paradox theory in corporate sustainability (CS), there is a lack of systematic analyses of both the antecedents and the maintenance of the active strategy for managing paradoxical tensions. This systematic literature review examines the individual, organisational and inter‐organisational antecedents, hereinafter roots of paradoxes (RPs), behind the active strategies aimed at managing paradoxical tensions in CS. The paper also analyses the active and defensive strategies used to manage paradoxical tensions at the organisational level, considering the role of both organisational strategic levels (corporate, business, tactical and operational) and inter‐organisational relationships. This review provides an integrative framework of the individual, organisational and inter‐organisational RPs and practices favouring the adoption of active strategies for managing paradoxical tensions. The analysis of the dynamics of transition from active to defensive strategies also highlights that the long‐term implementation of the active strategy requires its stratification within the organisational strategic levels. This study contributes to the literature on paradox theory in CS by understanding the mechanisms that sustain active management. Managerial implications are also illustrated. [ABSTRACT FROM AUTHOR]