Peri-tumoral metallic implants reduce the efficacy of irreversible electroporation for the ablation of colorectal liver metastases Journal Article

Authors: Cornelis, F. H.; Cindrič, H.; Kos, B.; Fujimori, M.; Petre, E. N.; Miklavčič, D.; Solomon, S. B.; Srimathveeravalli, G.
Article Title: Peri-tumoral metallic implants reduce the efficacy of irreversible electroporation for the ablation of colorectal liver metastases
Abstract: Purpose: To evaluate the effect of peri-tumoral metallic implants (MI) on the safety and efficacy of percutaneous irreversible electroporation (IRE) of colorectal liver metastasis (CRLM). Materials and Methods: In this retrospective study, 25 patients (12 women, 13 men; MI: 13, no MI: 12) were treated for 29 CRLM. Patient characteristics, tumor location and size, treatment parameters and the presence of MI were evaluated as determinants of local tumor progression (LTP) with the competing risks model (univariate and multivariate analyses). Patient-specific computer models were created to examine the effect of the MI on the electric field used to induce IRE, probability of cell kill and potential thermal effects. Results: Patients had a median follow-up of 25 months, during which no IRE-related major complications were reported. Univariate analysis showed that tumor size (> 2 cm), probe spacing (> 20 mm) and the presence of MI (p < 0.05) were significant predictors of time to LTP, but only the latter was found to be an independent predictor on multivariate analysis (sub-hazard ratio = 6.5; [95% CI 1.99, 21.4]; p = 0.002). The absence of peri-tumoral MI was associated with higher progression-free survival at 12 months (92.3% [56.6, 98.9] vs 12.5% [2.1, 32.8]). Computer simulations indicated significant distortions and reduction in electric field strength near MI, which could have contributed to under-treatment of the tumor. Conclusions: Peri-tumoral MI increases the risk of treatment failure following IRE of CRLM. © 2019, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Keywords: survival; adult; cancer survival; clinical article; controlled study; cancer surgery; survival rate; treatment failure; overall survival; patient selection; positron emission tomography; follow up; cell death; tumor localization; image analysis; tumor volume; cohort analysis; retrospective study; cancer mortality; postoperative complication; survival time; liver; pneumothorax; contrast enhancement; tumor recurrence; patient safety; surgical risk; blood vessel injury; surgical drainage; contrast medium; computer simulation; sex difference; tumor growth; computer model; urine retention; cell killing; liver injury; electric potential; colorectal metastasis; tumor ablation; bile duct injury; thermal injury; irreversible electroporation; local tumor progression; cancer prognosis; thermal exposure; duodenum injury; colorectal liver metastasis; human; male; female; priority journal; article; x-ray computed tomography; local progression free survival; computer simulations; percutaneous irreversible electroporation; pulsed electric field
Journal Title: CardioVascular and Interventional Radiology
Volume: 43
Issue: 1
ISSN: 0174-1551
Publisher: Springer  
Date Published: 2020-01-01
Start Page: 84
End Page: 93
Language: English
DOI: 10.1007/s00270-019-02300-y
PUBMED: 31385006
PROVIDER: scopus
PMCID: PMC6942240
Notes: Article -- Export Date: 3 February 2020 -- Source: Scopus
Citation Impact
MSK Authors
  1. Stephen Solomon
    302 Solomon
  2. Elena Nadia Petre
    58 Petre