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Recurrence patterns following irreversible electroporation for hepatic malignancies
Author(s) -
Langan Russell C.,
Goldman Debra A.,
D'Angelica Michael I.,
DeMatteo Ronald P.,
Allen Peter J.,
Balachandran Vinod P.,
Jarnagin William R.,
Kingham T. Peter
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24570
Subject(s) - medicine , irreversible electroporation , ablation , surgery , ablative case , incidence (geometry) , radiation therapy , electroporation , biochemistry , chemistry , physics , optics , gene
Background Irreversible electroporation (IRE) has emerged as a novel, safe ablative therapy for peri‐vascular lesions. However, there remains a paucity of data on long‐term outcomes. Methods We identified patients who underwent open IRE (1/2011‐6/2015) for primary and secondary hepatic malignancies. Local ablation‐zone recurrence (LR) was determined by cross‐sectional imaging. Cumulative incidence (CumI) of LR was calculated and a competing risks regression assessed factors associated with LR. Results Forty patients had 77 lesions treated. The majority of lesions were of colorectal origin (74%). Median tumor size was 1.3 cm (range 0.5‐6). Most patients (86%) had prior systemic therapy and 29% received systemic therapy following IRE. With a median follow‐up of 25.7 months (range 4.5‐58.8 months), 10 lesions in 9 patients recurred locally (CumI: 13.4%, 95%CI: 7.8‐22.2%). Median estimated time to LR was not reached and no LR occurred after 19 months. Factors significantly associated with LR included ablation zone size (HR 1.58; 95%CI 1.12‐2.23; P = 0.0093) and body mass index (HR 1.21 95%CI 1.10‐1.34; P = 0.0001). Conclusion IRE LR rates were low after the treatment of well selected, small tumors. This technique is useful for lesions in anatomic locations precluding resection or thermal ablation.