Irreversible Electroporation For Hepatocellular Carcinoma: Longer-Term Outcomes At A Single Centre

E. Freeman, W. Cheung, H. Kavnoudias, A. Majeed, W. Kemp, S. K. Roberts

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Abstract

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.

Original languageEnglish
Pages (from-to)247-253
Number of pages7
JournalCardioVascular and Interventional Radiology
Volume44
Issue number2
DOIs
Publication statusPublished - Feb 2021

Keywords

  • Ablation
  • Electroporation
  • Hepatocellular Carcinoma
  • Irreversible Electroporation
  • Liver Neoplasms
  • Microwave Ablation
  • Radiofrequency Ablation
  • Recurrence
  • Survival
  • Tumour

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