Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Division of Surgery, Department of Clinical Sciences, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden.
Eur J Surg Oncol. 2023 Nov;49(11):107046. doi: 10.1016/j.ejso.2023.107046. Epub 2023 Aug 31.
A nationwide multicenter study was performed to examine short- and long-term effects of irreversible electroporation (IRE) for hepatocellular carcinoma (HCC) and colorectal cancer liver metastases (CRCLM). IRE is an alternative method when thermal ablation is contraindicated because of risk for serious thermal complications.
All consecutive patients in Sweden treated with IRE because of HCC or CRCLM, were included between 2011 and 2018. We evaluated medical records and radiological imaging to obtain information regarding patient-, tumor-, and treatment characteristics. We also assessed local tumor progression, and survival.
In total 206 tumors in 149 patients were treated with IRE. Eighty-seven patients (58.4%) had colorectal cancer liver metastases, and 62 patients (41.6%) had hepatocellular carcinoma. Median tumor size was 20 mm (i.q.r. 14-26 mm). Median overall survival for CRCLM and HCC, were 27.0 months (95% CI 22.2-31.8 months), and 35.0 months (95% CI 13.8-56.2 months), respectively. Median follow-up time was 58 months (95% CI 50.6-65.4). Local ablation success at six and twelve months for HCC was 58.3% and 40.3%, and for CRCLM 37.7% and 25.4%. The median time to local tumor progression (LTP) for HCC was 21.0 months (95% CI: 9.5-32.5 months), and for CRCLM 6.0 months (95% CI: 4.5-7.5 months). At 30-day follow-up, 15.4% (n = 23) of patients suffered from a complication rated as Clavien-Dindo grade 1-3a. Three patients (2.0%) had grade 3b-5 with one death in a thromboembolic event.
IRE is a safe ablation modality for patients with liver tumors that are located in such a way that other treatment options are unsuitable.
一项全国多中心研究旨在探讨不可逆电穿孔（IRE）治疗肝细胞癌（HCC）和结直肠癌肝转移（CRCLM）的短期和长期效果。当由于严重的热并发症风险而不适合热消融时，IRE 是一种替代方法。
2011 年至 2018 年间，瑞典对因 HCC 或 CRCLM 而接受 IRE 治疗的所有连续患者进行了研究。我们评估了病历和影像学检查结果，以获得有关患者、肿瘤和治疗特征的信息。我们还评估了局部肿瘤进展和生存情况。
总共对 149 名患者的 206 个肿瘤进行了 IRE 治疗。87 名患者（58.4%）患有结直肠癌肝转移，62 名患者（41.6%）患有肝细胞癌。肿瘤大小中位数为 20mm（IQR：14-26mm）。CRCLM 和 HCC 的中位总生存期分别为 27.0 个月（95%CI：22.2-31.8 个月）和 35.0 个月（95%CI：13.8-56.2 个月）。中位随访时间为 58 个月（95%CI：50.6-65.4）。HCC 的局部消融成功率在 6 个月和 12 个月时分别为 58.3%和 40.3%，CRCLM 分别为 37.7%和 25.4%。HCC 的局部肿瘤进展（LTP）中位时间为 21.0 个月（95%CI：9.5-32.5 个月），CRCLM 为 6.0 个月（95%CI：4.5-7.5 个月）。在 30 天随访时，15.4%（n=23）的患者出现了 1-3a 级 Clavien-Dindo 分级的并发症。3 名患者（2.0%）出现 3b-5 级并发症，其中 1 例因血栓栓塞事件死亡。
IRE 是一种安全的消融方法，适用于那些由于位置原因不适合其他治疗方法的肝脏肿瘤患者。
