Irreversible electroporation for colorectal cancer liver metastasis: a review

Koethe, Yilun; Wilson, Nicole M.; Narayanan, Govindarajan

doi:10.1080/02656736.2021.2008025

Cited by 7 publications

(7 citation statements)

References 39 publications

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“…It raises the discussion of additional ablation, which could be provided by replacing the needle or by inserting a second or even a third needle to better control the thermoablation area. Irreversible Electroporation [ 35 , 36 , 37 , 38 ] and High-Intensity Focused Ultrasounds [ 39 , 40 ] are alternative ablation techniques for such lesions, their efficacy and safety have been demonstrated in many studies especially for colorectal liver metastases treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Larger size of the lesion to treat and proximity to blood vessels (especially hepatic veins) are risk factors for local recurrence that need to be considered when deciding on the ablation strategy, by adjusting the number of needles and the heating parameters to the lesion to treat or by taking a different approach with non-thermal ablations. Thermoablation of local recurrence occurring at a previous thermoablation site should be reserved for specific situations, since there is a higher risk of further local recurrence, given the almost identical primary and secondary efficacy rates, and this should also be balanced with alternative ablation techniques (IRE, HIFU) [ 35 , 36 , 37 , 39 ]. A non-ovoid thermoablation site shape on routine control imaging should prompt consideration of an early additional thermoablation procedure given the likelihood of a suboptimal distribution of the heat and the risk of a subsequent local recurrence.…”

Section: Discussionmentioning

confidence: 99%

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Predictive Factors of Local Recurrence after Colorectal Cancer Liver Metastases Thermal Ablation

et al. 2023

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Background: Identify risk factors for local recurrence (LR) after radiofrequency (RFA) and microwave (MWA) thermoablations (TA) of colorectal cancer liver metastases (CCLM). Methods: Uni- (Pearson’s Chi2 test, Fisher’s exact test, Wilcoxon test) and multivariate analyses (LASSO logistic regressions) of every patient treated with MWA or RFA (percutaneously and surgically) from January 2015 to April 2021 in Centre Georges François Leclerc in Dijon, France. Results: Fifty-four patients were treated with TA for 177 CCLM (159 surgically, 18 percutaneously). LR rate was 17.5% of treated lesions. Univariate analyses by lesion showed factors associated with LR: sizes of the lesion (OR = 1.14), size of nearby vessel (OR = 1.27), treatment of a previous TA site LR (OR = 5.03), and non-ovoid TA site shape (OR = 4.25). Multivariate analyses showed that the size of the nearby vessel (OR = 1.17) and the lesion (OR = 1.09) remained significant risk factors of LR. Conclusions: The size of lesions to treat and vessel proximity are LR risk factors that need to be considered when making the decision of thermoablative treatments. TA of an LR on a previous TA site should be reserved to specific situations, as there is an important risk of another LR. An additional TA procedure can be discussed when TA site shape is non-ovoid on control imaging, given the risk of LR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictive Factors of Local Recurrence after Colorectal Cancer Liver Metastases Thermal Ablation

et al. 2023

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“…The safety of IRE within 1.0 cm from critical structures is evident. Additionally, the procedure is efficacious even for tumours abutting or encasing large high-flow vascular structures such as the portal vein and hepatic arteries [ 83 , 84 ]. Other typical applications of IRE are tumour ablation near bile ducts, the gallbladder, or the bowel [ 85 , 86 , 87 ].…”

Section: Irreversible Electroporationmentioning

confidence: 99%

Pulsed Electric Fields in Oncology: A Snapshot of Current Clinical Practices and Research Directions from the 4th World Congress of Electroporation

Campana

Daud

Lancellotti

et al. 2023

Cancers

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The 4th World Congress of Electroporation (Copenhagen, 9–13 October 2022) provided a unique opportunity to convene leading experts in pulsed electric fields (PEF). PEF-based therapies harness electric fields to produce therapeutically useful effects on cancers and represent a valuable option for a variety of patients. As such, irreversible electroporation (IRE), gene electrotransfer (GET), electrochemotherapy (ECT), calcium electroporation (Ca-EP), and tumour-treating fields (TTF) are on the rise. Still, their full therapeutic potential remains underappreciated, and the field faces fragmentation, as shown by parallel maturation and differences in the stages of development and regulatory approval worldwide. This narrative review provides a glimpse of PEF-based techniques, including key mechanisms, clinical indications, and advances in therapy; finally, it offers insights into current research directions. By highlighting a common ground, the authors aim to break silos, strengthen cross-functional collaboration, and pave the way to novel possibilities for intervention. Intriguingly, beyond their peculiar mechanism of action, PEF-based therapies share technical interconnections and multifaceted biological effects (e.g., vascular, immunological) worth exploiting in combinatorial strategies.

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“… 108 Although IRE has proportionally most limited data regarding treatment outcomes, it is a modality that has a niche application, with outcomes to date suggesting similar outcomes to standard thermal ablative techniques. 109 Regardless of the modality used, careful patient selection and application of technique are crucial to effective outcomes. Achieving a suitable ablation margin of at least 5–10 mm has also been shown to correlate with more effective tumor control and recurrence-free intervals.…”

Section: Clinical Progress In Crlmmentioning

confidence: 99%

Updated Management of Colorectal Cancer Liver Metastases: Scientific Advances Driving Modern Therapeutic Innovations

Patel,

Rahman,

Schwantes

et al. 2023

Cellular and Molecular Gastroenterology and Hepatology

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Irreversible electroporation for colorectal cancer liver metastasis: a review

Cited by 7 publications

References 39 publications

Predictive Factors of Local Recurrence after Colorectal Cancer Liver Metastases Thermal Ablation

Predictive Factors of Local Recurrence after Colorectal Cancer Liver Metastases Thermal Ablation

Pulsed Electric Fields in Oncology: A Snapshot of Current Clinical Practices and Research Directions from the 4th World Congress of Electroporation

Updated Management of Colorectal Cancer Liver Metastases: Scientific Advances Driving Modern Therapeutic Innovations

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