Irreversible electroporation in HPB cancer treatment - A new ablation modality

Aims: Irreversible electroporation (IRE) is a new non-thermal ablation with promising effect on local tumor treatment. The electrical energy induces cell death while sparing vessels, bile ducts, nerves and other structures. In contrast to microwave and radiofrequency ablation, this technique does not cause heat-sink effect, and has been increasingly applied as an alternative treatment for different type of cancers. The goal of this study was to evaluate feasibility and safety of this novel ablation treatment. Methods: Twenty patients treated with IRE were included. Safety and feasibility were assessed based on adverse effects and technical success. Complications were scored by Clavien-Dindo classification from I to V. Results: The procedure was feasible in 100% cases. Type of tumor was colorectal liver metastasis (40%) followed by unresectable pancreatic cancer 25%, unresectable cholangiocarcinoma (15%) and others (20%). During IRE application, 3 patients presented arrhythmia, generator system problem in 1 case. Post-ablation complications were pancreatic fistula (grade IIIa), biliary stenose (grade IIIa), portal vein thrombosis (grade II), ascites (grade II). The local free survival rate was 90%, 86%, 52% in 3, 6 and 12 months. There was no death related to the procedure. Conclusions: IRE ablation seems to be a safe and feasible treatment for otherwise unresectable local tumors.