Percutaneous Irreversible Electroporation for the Treatment of Colorectal Cancer Liver Metastases with a Proposal for a New Response Evaluation System

Hosein, Peter J.; Echenique, Ana; Loaiza‐Bonilla, Arturo; Froud, Tatiana; Barbery, K.J.; Lima, Caio M. Rocha; Yrizarry, Jose M.; Narayanan, Govindarajan

doi:10.1016/j.jvir.2014.04.007

Cited by 52 publications

(30 citation statements)

References 29 publications

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“…The risk of recurrence seems to be higher for tumors >3 cm in size [58][59][60]. A 2014 retrospective review of 29 patients who underwent percutaneous IRE of 58 CLM showed a median PFS of 4 months, with estimated PFS and overall survival rates of 18 and 62%, respectively, at 2 years [61]. Radiologic response by RECIST criteria was an independent predictor for local PFS and overall survival [61].…”

Section: Cryoablationmentioning

confidence: 99%

“…A 2014 retrospective review of 29 patients who underwent percutaneous IRE of 58 CLM showed a median PFS of 4 months, with estimated PFS and overall survival rates of 18 and 62%, respectively, at 2 years [61]. Radiologic response by RECIST criteria was an independent predictor for local PFS and overall survival [61]. Current evidence, while encouraging, is still limited, with no randomized control trials.…”

Section: Cryoablationmentioning

confidence: 99%

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Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Petre

Sofocleous

2017

Visc Med

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Background: Surgical resection of limited colorectal liver disease improves long-term survival and can be curative in a subset of selected cases. Image-guided percutaneous ablation therapies have emerged as safe and effective alternative options for selected patients with unresectable colorectal liver metastases (CLM) that can be ablated with margins. Ablation causes focal destruction of tissue and has increasingly been shown to provide durable eradication of tumors. Methods: A selective review of literature was conducted in PubMed, focusing on recent studies reporting on the safety, efficacy, and long-term outcomes of percutaneous ablation modalities in the treatment of CLM. The present work gives an overview of the different ablation techniques, their current clinical indications, and reported outcomes from most recently published studies. The ‘test of time' concept for using ablation as a first local therapy is also described. Results: There are several thermal ablative tools currently available, including radiofrequency ablation (RFA), microwave ablation, and cryoablation. Most data to date originated from the application of RFA. Adjuvant thermal ablation in the treatment of oligometastatic colon cancer liver disease offers improved oncologic outcomes. The ideal CLM amenable to percutaneous ablation is a solitary tumor with the largest diameter up to 3 cm that can be completely ablated with a sufficient margin. 5-year overall survival rates up to 70% after ablation of unresectable CLM have been reported. Pathologic confirmation of complete tumor necrosis with margins over 5 mm provides best long-term local tumor control by thermal ablation. Conclusion: Current evidence suggests that percutaneous ablation as adjuvant to chemotherapy improves oncologic outcomes of patients with CLM. For small tumors that can be ablated completely with clear margins, percutaneous ablation may offer outcomes similar to those of surgery.

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Section: Cryoablationmentioning

confidence: 99%

Section: Cryoablationmentioning

confidence: 99%

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Petre

Sofocleous

2017

Visc Med

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“…Another retrospective study reported by Hosein and Loaiza-Bonilla [47] analyzed 29 patients (28 evaluable) who underwent 36 IRE sessions on 58 tumors for the management of colorectal liver metastasis between March 2010 and February 2013. All patients were assessed by CT scan immediately after IRE treatment, most had subsequent CT scans after 30 days according to patients’ condition.…”

Section: Ire Of Hepatic Tumors In Clinical Settingsmentioning

confidence: 99%

Irreversible electroporation in primary and metastatic hepatic malignancies

Lyu

Wang

et al. 2017

Medicine

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Background:Liver cancer makes up a huge percentage of cancer mortality worldwide. Irreversible electroporation (IRE) is a relatively new minimally invasive nonthermal ablation technique for tumors that applies short pulses of high frequency electrical energy to irreversibly destabilize cell membrane to induce tumor cell apoptosis.Methods:This review aims to investigate the studies regarding the use of IRE treatment in liver tumors and metastases to liver. We searched PubMed for all of IRE relevant English language articles published up to September 2016. They included clinical trials, experimental studies, observational studies, and reviews. This review manuscript is nothing with ethics issues and ethical approval is not provided.Results:In recent years, increasingly more studies in both preclinical and clinical settings have been conducted to examine the safety and efficacy of this new technique, shedding light on the crucial advantages and disadvantages that IRE possesses. Unlike the current leading thermal ablation techniques, such as radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation, IRE requires shorter ablation time without damaging adjacent important vital structures.Conclusion:Although IRE has successfully claimed its valuable status in the field of hepatic cancer treatment both preclinical and clinical settings. In order to systemically test and establish its safety and efficacy for clinical applications, more studies still need to be conducted.

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“…A recent prospective study of IRE treatment of 44 patients with HCC, colorectal, and other lesions reported the following local, recurrence-free survival rates: 97.4% at 3 months, 94.6% at 6 months and 59.5% at 12 months, the recurrence rates tended to be higher in lesions with diameter >4 cm (32). In a smaller cohort of 28 patients treated with IRE, portal vein thrombosis was reported in only 1 case in which the tumor was located within 1 cm of a major portal pedicle (33). Based on the findings, the authors of the study concluded that IRE was safe even for the treatment of liver lesions present near major vascular structures, and their findings are consistent with the reported theoretical benefits of non-thermal ablation (34)(35)(36).…”

Section: Discussionmentioning

confidence: 96%

Irreversible electroporation of malignant liver tumors: Effect on laboratory values

et al. 2018

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Liver cancer is often associated with chronic liver diseases. Treatment with percutaneous irreversible electroporation (IRE) may preserve liver function. In the present study, the clinical data of 29 patients with liver tumors between July 2015 and December 2016, all of whom underwent liver IRE at Fuda Cancer Hospital, Guangzhou, China was retrospectively reviewed. All the patients survived the treatment. Of the 29 patients, 7 were positive for hepatitis B, 15 had hepatocellular carcinoma (HCC) and 7 had pancreatic cancer with liver metastases. All patients survived IRE. Despite liver-protective treatment prior to IRE, the mean alanine transaminase (ALT) and aspartate transaminase (AST) levels were significantly elevated 1-2 days after IRE, to 540 and 712 U/l, respectively; however they had returned to the preoperative values by 2 weeks following IRE. Prior to IRE, the mean total bilirubin and direct bilirubin measurement levels were normal; however, 8-10 days after IRE, they had increased to 24 U/l and 12 µmol/l, respectively, and had returned back to the preoperative levels by 2 weeks after IRE. This first group included all patients. The result of the 4 subgroups of cancer patients demonstrated a variation between different measurement days and recovery with patients positive for the hepatitis B virus taking the longest duration to recover (17±3 days) meanwhile patients with pancreatic cancer with liver metastases took the shortest time to achieve recovery (10.78±2 days). The findings of the present study indicate that hepatic injury caused by IRE is transient and self-limiting in patients with liver tumors.

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Percutaneous Irreversible Electroporation for the Treatment of Colorectal Cancer Liver Metastases with a Proposal for a New Response Evaluation System

Cited by 52 publications

References 29 publications

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Thermal Ablation in the Management of Colorectal Cancer Patients with Oligometastatic Liver Disease

Irreversible electroporation in primary and metastatic hepatic malignancies

Irreversible electroporation of malignant liver tumors: Effect on laboratory values

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