Irreversible electroporation as a definitive treatment for early-stage HCC unsuitable for thermal ablation: insights from a tertiary liver centre
Year: 2025
Type: article
Study design: Observational Study
Abstract: Purpose Hepatocellular carcinoma (HCC) in its early stages is commonly treated with curative options such as liver transplantation, surgical resection, and thermal ablation. Thermal ablation is considered the first-line treatment for early-stage HCC (< 3 cm) when surgical interventions are not feasible. However, its effectiveness is limited for tumours located near (≤ 5 mm) large vessels due to the heat sink effect, and it poses a higher risk of complications when applied near critical structures such as bile ducts, blood vessels, the gallbladder, and the bowel. Percutaneous irreversible electroporation (IRE) is a predominantly non-thermal loco-regional therapeutic alternative for high-risk liver tumours that are unsuitable for thermal ablation. Methods We retrospectively analysed 54 patients who were treated in our unit between 2014 and 2022. The median follow-up period was 31 months. Results The median tumour size was 2.2 cm. Radiologic complete response (CR) was achieved after 83.9% of procedures. Recurrence was observed in 15 procedures (31.9%) during a median imaging follow-up time of 31.7 months (interquartile range: 14.3 – 43.2). Overall mean local tumour progression-free survival (LTPS) was 41.6 months (95% confidence interval (CI): 35.5 – 47.7 months). LTPS at 6 months, 1 year, and 2 years were 91.5% (95% CI: 83.5 – 99.5), 78.4% (95% CI: 67.6 – 90.2) and 73.7% (95% CI: 61.0–86.4), respectively. The complication rate was 10.7% ( n = 6/56), 2 being graded Clavien-Dindo I, 2 grade II and 2 grade IIIa. Conclusion Our findings provide insights into the potential role of IRE as a viable treatment option for high-risk HCC cases, addressing both oncological outcomes and treatment-related complications.
Source: CVIR Oncology
Institution: King's College Hospital
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,990
OpenAlex ID: W4415408381