TY - JOUR
T1 - Irreversible Electroporation For Hepatocellular Carcinoma
T2 - Longer-Term Outcomes At A Single Centre
AU - Freeman, E.
AU - Cheung, W.
AU - Kavnoudias, H.
AU - Majeed, A.
AU - Kemp, W.
AU - Roberts, S. K.
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background and Aims: Irreversible electroporation (IRE) is a non-thermal ablation technique for unresectable hepatocellular carcinoma (HCC) not amenable to standard thermal ablation. The aim of this study was to report our longer-term outcomes using this treatment modality. Method: We identified all patients at our institution who underwent IRE for HCC between December 2008 and October 2019 as recommended after multi-disciplinary team review. Demographic, clinical, tumour response and survival data up until 1 March, 2020 were analysed. The primary outcome was local recurrence-free survival (LRFS) in patients who had a complete response (CR). Secondary outcomes included CR rates, procedure-related complications and the incidence of death or liver transplantation. Results: A total of 23 patients (78% males, median age 65.2 years) received IRE therapy to 33 HCC lesions during the study period with the median tumour size being 2.0 cm (range 1.0–5.0 cm). Twenty-nine (87.9%) lesions were successfully ablated after one (n = 26) or two (n = 3) procedures. The median follow-up time for these lesions was 20.4 months. The median overall LRFS was 34.5 (95% CI 24.8 -) months with a 6- and 12-month LRFS of 87.9% (95% CI 75.8–100) and 83.6% (95% CI 70.2–99.7), respectively. Tumours < 2 cm had a 12-month LRFS of 100% (95% CI 100–100). Conclusion: IRE appears to be an efficacious local ablative method for early stage HCC not amenable to standard ablative techniques, with very good CR rates and longer-term LRFS, particularly for smaller lesions. Further studies comparing this technique to more widely accepted ablative methods such as radiofrequency and microwave ablation are warranted.
AB - Background and Aims: Irreversible electroporation (IRE) is a non-thermal ablation technique for unresectable hepatocellular carcinoma (HCC) not amenable to standard thermal ablation. The aim of this study was to report our longer-term outcomes using this treatment modality. Method: We identified all patients at our institution who underwent IRE for HCC between December 2008 and October 2019 as recommended after multi-disciplinary team review. Demographic, clinical, tumour response and survival data up until 1 March, 2020 were analysed. The primary outcome was local recurrence-free survival (LRFS) in patients who had a complete response (CR). Secondary outcomes included CR rates, procedure-related complications and the incidence of death or liver transplantation. Results: A total of 23 patients (78% males, median age 65.2 years) received IRE therapy to 33 HCC lesions during the study period with the median tumour size being 2.0 cm (range 1.0–5.0 cm). Twenty-nine (87.9%) lesions were successfully ablated after one (n = 26) or two (n = 3) procedures. The median follow-up time for these lesions was 20.4 months. The median overall LRFS was 34.5 (95% CI 24.8 -) months with a 6- and 12-month LRFS of 87.9% (95% CI 75.8–100) and 83.6% (95% CI 70.2–99.7), respectively. Tumours < 2 cm had a 12-month LRFS of 100% (95% CI 100–100). Conclusion: IRE appears to be an efficacious local ablative method for early stage HCC not amenable to standard ablative techniques, with very good CR rates and longer-term LRFS, particularly for smaller lesions. Further studies comparing this technique to more widely accepted ablative methods such as radiofrequency and microwave ablation are warranted.
KW - Ablation
KW - Electroporation
KW - Hepatocellular Carcinoma
KW - Irreversible Electroporation
KW - Liver Neoplasms
KW - Microwave Ablation
KW - Radiofrequency Ablation
KW - Recurrence
KW - Survival
KW - Tumour
UR - http://www.scopus.com/inward/record.url?scp=85092479497&partnerID=8YFLogxK
U2 - 10.1007/s00270-020-02666-4
DO - 10.1007/s00270-020-02666-4
M3 - Article
C2 - 33051707
AN - SCOPUS:85092479497
SN - 0174-1551
VL - 44
SP - 247
EP - 253
JO - CardioVascular and Interventional Radiology
JF - CardioVascular and Interventional Radiology
IS - 2
ER -