Irreversible Electroporation for Unresectable Hepatocellular Carcinoma: Initial Experience

Area of Science:

• Hepatobiliary surgery
• Interventional oncology
• Minimally invasive cancer treatment

Background:

• Hepatocellular carcinoma (HCC) is a primary liver cancer with limited treatment options for unresectable cases.
• Thermal ablation techniques are standard but may have limitations.
• Irreversible electroporation (IRE) offers a non-thermal ablation alternative.

Purpose of the Study:

• To assess the efficacy and safety of irreversible electroporation (IRE) for unresectable hepatocellular carcinoma (HCC).
• To identify factors influencing treatment outcomes in HCC patients undergoing IRE.

Main Methods:

• Retrospective analysis of 21 patients with unresectable HCC treated with IRE between September 2014 and June 2017.
• Evaluation of technical success, local recurrence rates, progression-free survival (PFS), and complications.
• Analysis of tumor characteristics (size, location) and patient factors in relation to PFS.

Main Results:

• Technical success was achieved in all patients, with a median follow-up of 10 months.
• Median time to local recurrence was 4 months, and median local tumor PFS was 7 months.
• Tumor size ≤25 mm was significantly associated with improved local PFS (p=0.045); complications were mild (Grade 1-2) in 9 patients, with no mortality.

Conclusions:

• Irreversible electroporation (IRE) demonstrates efficacy in ablating small, unresectable HCCs.
• Tumor size is a critical factor for successful local tumor control with IRE.
• Further prospective studies are warranted to establish IRE's role in unresectable HCC, especially for patients unsuitable for thermal ablation.