Electrolytic ablation is as effective as radiofrequency ablation in the treatment of artificial liver metastases in a pig model.
BACKGROUND
The best treatment option for liver metastases is complete surgical resection. Unfortunately, at the time of diagnosis, not all patients are candidates for complete resection. Electrolytic therapy (ECT) is a novel non-thermal method of tissue destruction. We evaluated its safety and effectiveness in comparison with radiofrequency ablation (RFA).


METHODS
Tumor mimics were created by injecting a gel into the pig liver. The volume of the lesions was measured by ultrasound before treatment. The tumor mimics were treated with either RFA or electrolytic ablation. 48 h after treatment the liver was fixed in formalin and subjected to histological examination.


RESULTS
Histological investigation confirmed that all lesions were completely surrounded by necrosis after treatment with either ECT or RFA. Two different types of necrosis were identified. After RFA the cell membranes disappeared but the nuclei were still intact, whereas after ECT these structures were completely disrupted. After ECT the necrosis was often surrounded by infiltrating lymphocytes. This inflammatory reaction was not apparent after RFA.


CONCLUSIONS
ECT produced predictable and reproducible necrosis in pig livers and was as effective as RFA at destroying a defined target lesion. A local inflammatory reaction after ECT may favour the development of a systemic immune response. Our results indicate that ECT is an alternative treatment option for irresectable liver metastases.
Department of General Surgery and Thoracic Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Germany. shinz@surgery.uni-kiel.de
Sebastian
S
Hinz
Jan-Hendrik
JH
Egberts
Ursula
U
Pauser
Clemens
C
Schafmayer
Fred
F
Fändrich
Jürgen
J
Tepel
D000818:Animals; D040761:Biomimetic Materials; D017115:Catheter Ablation; D002462:Cell Membrane / Q000473:pathology; D004195:Disease Models, Animal; D004572:Electrolysis; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008214:Lymphocytes / Q000378:metabolism; D009336:Necrosis; D013552:Swine