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Ablation of perivascular hepatic malignant tumors with irreversible electroporation.

Publication ,  Journal Article
Kingham, TP; Karkar, AM; D'Angelica, MI; Allen, PJ; Dematteo, RP; Getrajdman, GI; Sofocleous, CT; Solomon, SB; Jarnagin, WR; Fong, Y
Published in: J Am Coll Surg
September 2012

BACKGROUND: Ablation is increasingly used to treat primary and secondary liver cancer. Ablation near portal pedicles and hepatic veins is challenging. Irreversible electroporation (IRE) is a new ablation technique that does not rely on heat and, in animals, appears to be safe and effective when applied near hepatic veins and portal pedicles. This study evaluated the safety and short-term outcomes of IRE to ablate perivascular malignant liver tumors. STUDY DESIGN: A retrospective review of patients treated with IRE between January 1, 2011 and November 2, 2011 was performed. Patients were selected for IRE when resection or thermal ablation was not indicated due to tumor location. Treatment outcomes were classified by local, regional, and systemic recurrence and complications. Local failure was defined as abnormal enhancement at the periphery of an ablation defect on post-procedure contrast imaging. RESULTS: Twenty-eight patients had 65 tumors treated. Twenty-two patients (79%) were treated via an open approach and 6 (21%) were treated percutaneously. Median tumor size was 1 cm (range 0.5 to 5 cm). Twenty-five tumors were <1 cm from a major hepatic vein; 16 were <1 cm from a major portal pedicle. Complications included 1 intraoperative arrhythmia and 1 postoperative portal vein thrombosis. Overall morbidity was 3%. There were no treatment-associated mortalities. At median follow-up of 6 months, there was 1 tumor with persistent disease (1.9%) and 3 tumors recurred locally (5.7%). CONCLUSIONS: This early analysis of IRE treatment of perivascular malignant hepatic tumors demonstrates safety for treating liver malignancies. Larger studies and longer follow-up are necessary to determine long-term efficacy.

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Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

September 2012

Volume

215

Issue

3

Start / End Page

379 / 387

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Portal Vein
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Intraoperative Complications
 

Citation

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Kingham, T. P., Karkar, A. M., D’Angelica, M. I., Allen, P. J., Dematteo, R. P., Getrajdman, G. I., … Fong, Y. (2012). Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg, 215(3), 379–387. https://doi.org/10.1016/j.jamcollsurg.2012.04.029
Kingham, T Peter, Ami M. Karkar, Michael I. D’Angelica, Peter J. Allen, Ronald P. Dematteo, George I. Getrajdman, Constantinos T. Sofocleous, Stephen B. Solomon, William R. Jarnagin, and Yuman Fong. “Ablation of perivascular hepatic malignant tumors with irreversible electroporation.J Am Coll Surg 215, no. 3 (September 2012): 379–87. https://doi.org/10.1016/j.jamcollsurg.2012.04.029.
Kingham TP, Karkar AM, D’Angelica MI, Allen PJ, Dematteo RP, Getrajdman GI, et al. Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg. 2012 Sep;215(3):379–87.
Kingham, T. Peter, et al. “Ablation of perivascular hepatic malignant tumors with irreversible electroporation.J Am Coll Surg, vol. 215, no. 3, Sept. 2012, pp. 379–87. Pubmed, doi:10.1016/j.jamcollsurg.2012.04.029.
Kingham TP, Karkar AM, D’Angelica MI, Allen PJ, Dematteo RP, Getrajdman GI, Sofocleous CT, Solomon SB, Jarnagin WR, Fong Y. Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg. 2012 Sep;215(3):379–387.
Journal cover image

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

September 2012

Volume

215

Issue

3

Start / End Page

379 / 387

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Retrospective Studies
  • Postoperative Complications
  • Portal Vein
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Intraoperative Complications