Irreversible Electroporation: a Novel Option for Treatment of Hepatic Metastases

Irreversible electroporation (IRE) has shown promise for ablation of lesions in proximity to vital structures in the preclinical and now clinical setting. Studies of patients undergoing IRE for treatment of metastatic colorectal cancer to the liver were reviewed for patient and tumor characteristics, treatment-related complications, and local recurrence-free survival (LRFS) for ablated lesions. LRFS was calculated according to the Kaplan–Meier method, with secondary analyses stratified by procedural approach (laparotomy, laparoscopy, percutaneous) and tumor histological characteristics. Initial IRE success has been achieved in 95 % of treatments. The LRFS rates at 3, 6, and 12 months were 97.4 %, 94.6 %, and 59.5 %. There was a trend toward higher recurrence rates for tumors larger than 4 cm (hazard ratio 3.236, 95 % confidence interval 0.585-17.891; p=0. 178). IRE is a safe and effective treatment for metastatic colorectal cancer to the liver near vital structures. Continued evaluation is needed to determine optimal probe design and techniques.