title: Percutaneous Ablation of Hepatic Tumors Using Irreversible Electroporation: A Prospective Safety and Midterm Efficacy Study in 34 Patients.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of percutaneous irreversible electroporation (IRE) of primary and secondary liver cancer unsuitable for resection or thermal ablation.
  
  
  METHODS
  In this prospective, single-center study, 65 malignant liver tumors (hepatocellular carcinoma, n = 33; cholangiocellular carcinoma, n = 5; colorectal cancer metastasis, n = 22; neuroendocrine cancer metastasis, n = 3; testicular cancer metastasis, n = 2) in 34 patients (27 men, 7 women; mean age, 59.4 y ± 11.2) were treated. Local recurrence-free survival (LRFS) according to the Kaplan-Meier method was evaluated after a median follow-up of 13.9 months.
  
  
  RESULTS
  Median tumor diameter was 2.4 cm ± 1.4 (range, 0.2-7.1 cm). Of 65 tumors, 12 (18.5%) required retreatment because of incomplete ablation (n = 3) or early local recurrence (n = 9). LRFS at 3, 6, and 12 months was 87.4%, 79.8%, and 74.8%. The median time to progressive disease according to modified Response Evaluation Criteria In Solid Tumors was 15.6 months. Overall complication rate was 27.5% with six major complications and eight minor complications. Major complications included diffuse intraperitonal bleeding (n = 1), partial thrombosis of the portal vein (n = 1), and liver abscesses (n = 4). Minor complications were liver hematomas (n = 6) and clinically inapparent pneumothoraces (n = 2).
  
  
  CONCLUSIONS
  IRE showed promising results regarding therapeutic efficacy for the percutaneous treatment of liver tumors; however, significant concerns remain regarding its safety.
authors.affiliation: Department of Radiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany. Electronic address: christoph.niessen@ukr.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Niessen
authors.affiliation: Department of Radiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Lukas P
authors.initials: LP
authors.lastname: Beyer
authors.affiliation: Department of Radiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Pregler
authors.affiliation: Department of Radiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Dollinger
authors.affiliation: Department of Anesthesiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Trabold
authors.affiliation: Department of Surgery, University Hospital RegensburgFranz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Schlitt
authors.affiliation: Department of Radiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Ernst M
authors.initials: EM
authors.lastname: Jung
authors.affiliation: Department of Radiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.affiliation: Department of Radiology, Franz-Josef-Strauss-Allee 11, Regensburg D-93053, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D018274:Electroporation; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden