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Purpose <p>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 (&lt; 3&#xa0;cm) when surgical interventions are not feasible. However, its effectiveness is limited for tumours located near (≤ 5&#xa0;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.</p> Methods <p>We retrospectively analysed 54 patients who were treated in our unit between 2014 and 2022. The median follow-up period was 31&#xa0;months.</p> Results <p>The median tumour size was 2.2&#xa0;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&#xa0;months (interquartile range: 14.3 – 43.2). Overall mean local tumour progression-free survival (LTPS) was 41.6&#xa0;months (95% confidence interval (CI): 35.5 – 47.7&#xa0;months). LTPS at 6&#xa0;months, 1&#xa0;year, and 2&#xa0;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% (<i>n</i> = 6/56), 2 being graded Clavien-Dindo I, 2 grade II and 2 grade IIIa.</p> Conclusion <p>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.</p>

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Irreversible electroporation as a definitive treatment for early-stage HCC unsuitable for thermal ablation: insights from a tertiary liver centre

  • 期刊论文

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  • 发表日期：

    2025年10月22日

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  • Praveen Peddu,
  • Nuran Seneviratne,
  • Essam Hashem,
  • Cheng Fang

摘要

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.