Irreversible electroporation ablation of end‑stage metastatic retroperitoneal lesions: Report on three cases and literature review

Abstract

Metastatic retroperitoneal tumors constitute an end-stage disease with poor prognosis that represents a heavy global health burden. The present study aimed to explore the efficacy of irreversible electroporation ablation (IRE) therapy in patients with end-stage retroperitoneal tumors. Between April 2016 and September 2017, three patients with unresectable retroperitoneal malignant tumors were enrolled. Among these cases, ultrasound (US)-guided IRE was palliatively performed for targeting 3 tumors (1 tumor per patient) located around the abdominal aorta. Post-treatment contrast-enhanced US (CEUS) and contrast-enhanced computed tomography (CECT) scans were subsequently performed to evaluate the area adjacent to the ablation zone and determine the prognosis. During the follow-up, the cases experienced a reduction of pain (mean score of 5.8 decreased to 2.2, based on the visual analogue scale), and had an overall survival rate ranging from 2 to 11 months. Case 1 remained alive at the time of submission of this study, but case 2 died within 2 months and case 3 within 11 months due to liver metastases of the primary tumor. At the 3-week follow-up, the CEUS image for case 1 exhibited a contrast defect with a sufficient ablation margin, in accordance with the CECT at 1.5 months following IRE, exhibiting complete tumor necrosis without contrast enhancement. Overall, these results suggest that US-guided percutaneous IRE may be effective in the treatment of end-stage retroperitoneal tumors. However, further studies are required to substantiate the conclusions of the present study. The present clinical trial was registered at clinicaltrials.gov (ID: NCT02822066) on June 20th, 2016.

Immunomodulatory Effect of Irreversible Electroporation Alone and Its Cooperating With Immunotherapy in Pancreatic Cancer

“…In particular, it has advantages for lesions located in large vessels, the hilar region, bile duct, and ureter (7). Our center previously successfully treated the lesions located in the liver (8), portal vein tumor thrombus (9), and retroperitoneum (10). The follow-up of the patient after IRE showed that the lesions were completely ablated.…”

The Use of Ultrasound Contrast in Interventional Radiology

“…11 In addition to radiation and contrast sparing, the technique allows continuous imaging throughout the procedure and can confirm the successful ablation zone. 12 CEUS-guided ablation has been used in a multitude of regions, including the liver, 13 kidneys, 14 thyroid, 15 parathyroids, 16 retroperitoneum, 17 uterine fibroids, and abdominal wall endometriosis. 18,19 CEUS has been applied in a range of ablative modalities, including microwave ablation, alcohol ablation, radiofrequency ablation, cryoablation, and irreversible electroporation.…”

Irreversible Electroporation: An Emerging Immunomodulatory Therapy on Solid Tumors

“…One study on prostate cancer showed comparable efficacy of IRE to standard radical prostatectomy in terms of 5-year recurrence rate, and IRE showed better preservation of urogenital function (76). Two studies found good therapeutic value of IRE in metastatic cancer, including bilateral lung metastasis of osteosarcoma (77) and retroperitoneal metastasis of ovarian, gastric, and pancreatic cancer (78). Another study confirmed that IRE possesses an acceptable safety profile and is effective in eradicating difficultto-reach colorectal liver metastases (CRLMs) (61), while another study showed that IRE is not effective for the treatment of lung malignancies (59).…”