Recurrence patterns following irreversible electroporation for hepatic malignancies.

Journal Article (Journal Article)

BACKGROUND: Irreversible electroporation (IRE) has emerged as a novel, safe ablative therapy for peri-vascular lesions. However, there remains a paucity of data on long-term outcomes. METHODS: We identified patients who underwent open IRE (1/2011-6/2015) for primary and secondary hepatic malignancies. Local ablation-zone recurrence (LR) was determined by cross-sectional imaging. Cumulative incidence (CumI) of LR was calculated and a competing risks regression assessed factors associated with LR. RESULTS: Forty patients had 77 lesions treated. The majority of lesions were of colorectal origin (74%). Median tumor size was 1.3 cm (range 0.5-6). Most patients (86%) had prior systemic therapy and 29% received systemic therapy following IRE. With a median follow-up of 25.7 months (range 4.5-58.8 months), 10 lesions in 9 patients recurred locally (CumI: 13.4%, 95%CI: 7.8-22.2%). Median estimated time to LR was not reached and no LR occurred after 19 months. Factors significantly associated with LR included ablation zone size (HR 1.58; 95%CI 1.12-2.23; P = 0.0093) and body mass index (HR 1.21 95%CI 1.10-1.34; P = 0.0001). CONCLUSION: IRE LR rates were low after the treatment of well selected, small tumors. This technique is useful for lesions in anatomic locations precluding resection or thermal ablation.

Full Text

Duke Authors

Cited Authors

  • Langan, RC; Goldman, DA; D'Angelica, MI; DeMatteo, RP; Allen, PJ; Balachandran, VP; Jarnagin, WR; Kingham, TP

Published Date

  • May 2017

Published In

Volume / Issue

  • 115 / 6

Start / End Page

  • 704 - 710

PubMed ID

  • 28493544

Pubmed Central ID

  • PMC5647195

Electronic International Standard Serial Number (EISSN)

  • 1096-9098

Digital Object Identifier (DOI)

  • 10.1002/jso.24570

Language

  • eng

Conference Location

  • United States