title: Evaluation of tolerability and efficacy of irreversible electroporation (IRE) in treatment of Child-Pugh B (7/8) hepatocellular carcinoma (HCC).
abstract: Few studies have assessed the tolerability and efficacy of irreversible electroporation (IRE) in the treatment of Child-Pugh B (7/8) patients with hepatocellular carcinoma (HCC). Based on its mechanism of action, we hypothesized that IRE would be superior to microwave (MW) ablation and compared the liver tolerance and ablation success rates of these therapies in Child-Pugh B patients with HCC.
  
  
  
  55 patients with Child-Pugh B (7/8) HCC were treated with either MW ablation (n = 25) or IRE (n = 30). Tolerance and ablation success were evaluated at 30 and 90 days and 90 days and 6 months, respectively. Tolerance was defined as stable liver function and absence of increased ascites or worsening portal hypertension. Ablation success was defined as tumor eradication on triple phase contrasted computed tomography (CT).
  
  
  
  Patients undergoing IRE had shorter length of stay (p = 0.05) and 90 day readmission rate (p = 0.03) than those undergoing MW ablation. Additionally, IRE was better tolerated than MW ablation at 30 and 90 days. IRE and MW ablation resulted in 6 month success rates of 97% and 100%.
  
  
  
  Treatment of Child-Pugh B (7/8) HCC with IRE results in equivalent ablation success with improved liver tolerance compared with MW ablation and other ablative modalities.
authors.affiliation: University of Louisville - Surgery, Division of Surgical Oncology, Louisville, KY, United States.
authors.forename: Neal
authors.initials: N
authors.lastname: Bhutiani
authors.affiliation: University of Louisville - Surgery, Division of Surgical Oncology, Louisville, KY, United States.
authors.forename: Prejesh
authors.initials: P
authors.lastname: Philips
authors.affiliation: University of Louisville - Surgery, Division of Surgical Oncology, Louisville, KY, United States.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Scoggins
authors.affiliation: University of Louisville - Surgery, Division of Surgical Oncology, Louisville, KY, United States.
authors.forename: Kelly M
authors.initials: KM
authors.lastname: McMasters
authors.affiliation: University of Louisville - Radiology, Louisville, KY 40202, United States.
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Potts
authors.affiliation: University of Louisville - Surgery, Division of Surgical Oncology, Louisville, KY, United States. Electronic address: Robert.Martin@louisville.edu.
authors.forename: Robert C G
authors.initials: RC
authors.lastname: Martin
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018274:Electroporation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010359:Patient Readmission; D011183:Postoperative Complications / Q000209:etiology; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome