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Irreversible Electroporation for Unresectable Hepatocellular Carcinoma: Initial Experience

  • Naveen KalraEmail author
  • Pankaj Gupta
  • Ujjwal Gorsi
  • Harish Bhujade
  • Shreedhara B. Chaluvashetty
  • Ajay Duseja
  • Virendra Singh
  • Radha K. Dhiman
  • Yogesh K. Chawla
  • Niranjan Khandelwal
Clinical Investigation Interventional Oncology
  • 32 Downloads
Part of the following topical collections:
  1. Interventional Oncology

Abstract

Purpose

To evaluate the efficacy and safety of irreversible electroporation (IRE) in the treatment of unresectable hepatocellular carcinoma (HCC).

Materials and Methods

A retrospective study was conducted from September 2014 to June 2017. A total of 21 HCCs in 21 patients with cirrhosis were treated with IRE. There were eight subcapsular or exophytic, ten perivascular and three peribiliary tumors. The median tumor size was 26 mm (range 14–40 mm). The technical success of the procedure was recorded. Median follow-up, median time to local recurrence, median local tumor progression-free survival (PFS) and complications were recorded.

Results

Technical success was achieved in all the patients. The median follow-up was 10 months (range 2–30 months). The median time to local recurrence and local tumor PFS were 4 months (range 3–4 months) and 7 months (range 3–30 months), respectively. The tumor-related factor that was significantly associated with local PFS was the size. Maximum tumor diameter < 25 mm was significantly associated with local tumor PFS (p = 0.045). Other parameters including tumor location, segmental portal vein thrombosis, baseline alpha-fetoprotein level and underlying etiology did not affect local tumor PFS. Complications were noted in nine patients and were classified as grades 1 and 2. No procedure-related mortality was encountered.

Conclusion

IRE is an effective treatment for ablation of small HCCs. Larger prospective studies with strict selection criteria will establish the safety and efficacy of IRE in the treatment of unresectable HCC in patients who cannot undergo thermal ablation.

Keywords

Hepatocellular carcinoma Irreversible electroporation Radiofrequency ablation 

Notes

Acknowledgements

Karthik Rayasam and Kiruthika Palani, Residents of the Department of Radiodiagnosis and Imaging helped in data collection.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Procedural informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • Naveen Kalra
    • 1
    Email author
  • Pankaj Gupta
    • 2
  • Ujjwal Gorsi
    • 1
  • Harish Bhujade
    • 1
  • Shreedhara B. Chaluvashetty
    • 1
  • Ajay Duseja
    • 3
  • Virendra Singh
    • 3
  • Radha K. Dhiman
    • 3
  • Yogesh K. Chawla
    • 3
  • Niranjan Khandelwal
    • 1
  1. 1.Department of Radiodiagnosis and ImagingPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  2. 2.Department of GastroenterologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
  3. 3.Department of HepatologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia

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