title: Percutaneous irreversible electroporation for the treatment of colorectal cancer liver metastases with a proposal for a new response evaluation system.
abstract: OBJECTIVE
  To describe an initial experience with irreversible electroporation (IRE) in patients with colorectal liver metastasis (CLM).
  
  
  METHODS
  A retrospective analysis of patients undergoing IRE for the management of CLM was performed. Procedures were done percutaneously under general anesthesia. Patients were then followed for adverse events, tumor response, and survival.
  
  
  RESULTS
  Between March 2010 and February 2013, 29 patients underwent percutaneous ablation of 58 tumors in 36 IRE sessions. Most patients (89%) had an absolute or relative contraindication to thermal ablation. The median age was 62 years, and the median time from diagnosis to IRE was 28 months. The median number of lesions treated per patient was two, and the median tumor size was 2.7 cm. Patients had received previous chemotherapy regimens (range, 1-5 per patient). A new Metabolic Imaging And Marker Integration response evaluation criteria was used for response assessment, and was a predictor of progression-free and overall survival. The 2-year progression-free survival rate was 18% (95% confidence interval, 0%-35%), and the 2-year overall survival rate was 62% (95% confidence interval, 37%-87%). Complications included arrhythmias (n = 1) and postprocedure pain (n = 1). Both patients recovered without sequelae.
  
  
  CONCLUSIONS
  Percutaneous IRE of CLM is feasible and safe. A new response evaluation system for colorectal cancer appears to be prognostic.
authors.affiliation: Department of Medicine and Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136. Electronic address: phosein@med.miami.edu.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hosein
authors.affiliation: Department of Radiology and Division of Vascular/Interventional Radiology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136.
authors.forename: Ana
authors.initials: A
authors.lastname: Echenique
authors.affiliation: Department of Medicine and Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136.
authors.forename: Arturo
authors.initials: A
authors.lastname: Loaiza-Bonilla
authors.affiliation: Department of Radiology and Division of Vascular/Interventional Radiology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Froud
authors.affiliation: Department of Radiology and Division of Vascular/Interventional Radiology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136.
authors.forename: Katuzka
authors.initials: K
authors.lastname: Barbery
authors.affiliation: Department of Radiology and Division of Vascular/Interventional Radiology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136.
authors.forename: Caio M
authors.initials: CM
authors.lastname: Rocha Lima
authors.affiliation: Department of Radiology and Division of Vascular/Interventional Radiology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Yrizarry
authors.affiliation: Department of Radiology and Division of Vascular/Interventional Radiology, Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave., Suite 3400, Miami, FL 33136.
authors.forename: Govindarajan
authors.initials: G
authors.lastname: Narayanan
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D000368:Aged; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D053672:Electrochemotherapy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome