Percutaneous Ablation of Hepatic Tumors Using Irreversible Electroporation: A Prospective Safety and Midterm Efficacy Study in 34 Patients

• Published in: Journal of vascular and interventional radiology Vol. 27; no. 4; pp. 480 - 486
• Main Authors: Niessen, Christoph, Dr Med, Beyer, Lukas P., Dr Med, Pregler, Benedikt, MD, Dollinger, Marco, Dr Med, Trabold, Benedikt, PD Dr, Schlitt, Hans J., Prof Dr, Jung, Ernst M., Prof Dr, Stroszczynski, Christian, Prof Dr, Wiggermann, Philipp, PD Dr
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2016
• Subjects: Aged; Catheter Ablation - adverse effects; Catheter Ablation - methods; Catheter Ablation - mortality; Disease Progression; Disease-Free Survival; Electroporation; Female; Germany; Humans; Kaplan-Meier Estimate; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Recurrence, Local; Prospective Studies; Radiology; Reoperation; Risk Factors; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Tumor Burden; LRFS; CTCAE; mRECIST; local recurrence-free survival; modified Response Evaluation Criteria In Solid Tumors; IRE; irreversible electroporation; Common Terminology Criteria for Adverse Events
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2015.12.025

Abstract Purpose To evaluate the safety and efficacy of percutaneous irreversible electroporation (IRE) of primary and secondary liver cancer unsuitable for resection or thermal ablation. Materials and Methods In this prospective, single-center study, 65 malignant liver tumors (hepatocellular carcinoma, n = 33; cholangiocellular carcinoma, n = 5; colorectal cancer metastasis, n = 22; neuroendocrine cancer metastasis, n = 3; testicular cancer metastasis, n = 2) in 34 patients (27 men, 7 women; mean age, 59.4 y ± 11.2) were treated. Local recurrence-free survival (LRFS) according to the Kaplan-Meier method was evaluated after a median follow-up of 13.9 months. Results Median tumor diameter was 2.4 cm ± 1.4 (range, 0.2–7.1 cm). Of 65 tumors, 12 (18.5%) required retreatment because of incomplete ablation (n = 3) or early local recurrence (n = 9). LRFS at 3, 6, and 12 months was 87.4%, 79.8%, and 74.8%. The median time to progressive disease according to modified Response Evaluation Criteria In Solid Tumors was 15.6 months. Overall complication rate was 27.5% with six major complications and eight minor complications. Major complications included diffuse intraperitonal bleeding (n = 1), partial thrombosis of the portal vein (n = 1), and liver abscesses (n = 4). Minor complications were liver hematomas (n = 6) and clinically inapparent pneumothoraces (n = 2). Conclusions IRE showed promising results regarding therapeutic efficacy for the percutaneous treatment of liver tumors; however, significant concerns remain regarding its safety.