Electrochemotherapy of cholangiocellular carcinoma at hepatic hilum: A feasibility study

Tarantino, L.; Busto, Giuseppina; Nasto, Aurelio; Nasto, Riccardo Aurelio; Tarantino, Paolo; Fristachi, Raffaele; Cacace, Luigi; Bortone, Sara

doi:10.1016/j.ejso.2018.06.025

Cited by 30 publications

(28 citation statements)

References 34 publications

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“…Recently, the use of ECT has expanded to deep-seated visceral tumours 11 . Clinical trials of ECT for the treatment of colorectal liver metastases 12,13 , hepatocellular carcinoma 14 , cholangiocellular carcinoma 15 , and pancreatic adenocarcinoma have been published 16 . Most of the included patients had advanced, unresectable tumours that were located in high-risk areas near large blood vessels and/or bile ducts where surgery or thermal ablation techniques were not feasible and/or safe 12–16 .…”

Section: Introductionmentioning

confidence: 99%

Large Liver Blood Vessels and Bile Ducts Are Not Damaged by Electrochemotherapy with Bleomycin in Pigs

Žmuc

Gašljević

Serša

et al. 2019

Sci Rep

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The first clinical studies on the use of electrochemotherapy to treat liver tumours that were not amenable to surgery or thermal ablation techniques have recently been published. However, there is still a lack of data on the effects of electrochemotherapy on normal liver tissue. Therefore, we designed a translational animal model study to test whether electrochemotherapy with bleomycin causes clinically significant damage to normal liver tissue, with emphasis on large blood vessels and bile ducts. We performed electrochemotherapy with bleomycin or delivered electric pulses alone using a potentially risky treatment strategy in eight pigs. Two and seven days after treatment, livers were explanted, and histological analysis was performed. Blood samples were collected before treatment and again before euthanasia to evaluate blood biomarkers of liver function and systemic inflammatory response. We found no thrombosis or other clinically significant damage to large blood vessels and bile ducts in the liver. No clinical or laboratory findings suggested impaired liver function or systemic inflammatory response. Electrochemotherapy with bleomycin does not cause clinically significant damage to normal liver tissue. Our study provides further evidence that electrochemotherapy with bleomycin is safe for treatment of patients with tumours near large blood vessels in the liver.

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Section: Introductionmentioning

confidence: 99%

Large Liver Blood Vessels and Bile Ducts Are Not Damaged by Electrochemotherapy with Bleomycin in Pigs

Žmuc

Gašljević

Serša

et al. 2019

Sci Rep

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“…ECT is an established treatment modality for skin malignancies but has been also proposed for the treatment of hepatic tumors. Indeed, an Italian group recently published preliminary experience with ECT treatment of a few cases of hilar cholangiocarcinoma [9] and portal vein thrombosis due to HCC invasion [10] reporting promising results in terms of feasibility and effectiveness.…”

mentioning

confidence: 99%

Irreversible electroporation for hepatic tumors

Pompili

Francica

2019

J Ultrasound

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“…The treatment was considered effective and complete when the following findings were observed: (1) absence of contrast enhancement of the tumor in the one-month CT/MR image and 2progressive shrinkage of the tumor in the three-month CT/MR image. The treatment was considered partially effective or not effective when contrast enhancement of the tumor was still present in the one-month CT/MR image or new solid enhanced nodules or enlargement of the tumor mass was detected in the three-month CT/ MR image 8 . The percutaneous biliary drainage tube was removed after the procedure within three months if the bile duct was patent without evidence of obstructive jaundice, and it was replaced with an expandable metallic stent if necessary.…”

Section: Methodsmentioning

confidence: 99%

Clinical impact of irreversible electroporation ablation for unresectable hilar cholangiocarcinoma

Hsiao

Yang

et al. 2020

Sci Rep

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Irreversible electroporation (IRE) is a non-thermal ablation modality that has been shown to be safe and effective in its application to tumors that are close to risky areas. This study aims to assess the safety and efficacy of IRE for unresectable hilar cholangiocarcinoma. Nine patients from two medical centers in Asia received IRE treatment between June 2015 and July 2017. Before IRE treatment, percutaneous biliary decompressions had been performed on eight patients, and internal stenting had been performed on one patient. All patients tolerated the procedure well without high-grade complications. The ablated tumors had constant size without contrast enhancement for more than three months in eight patients and the level of CA19-9 decreased significantly in all patients. The percutaneous biliary drainage tube was removed from two patients with recanalization of the bile duct. The internal stent in one patient was removed without further stenting. The median overall survival period was 26 months, and the progression-free survival was 18 months. Bile ducts remained narrow in the majority (2/3) of the treated patients. Nevertheless, IRE ablation of unresectable hilar cholangiocarcinoma involving vital structures is a safe and feasible primary treatment for local tumor control and is effective in prolonging survival.

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Electrochemotherapy of cholangiocellular carcinoma at hepatic hilum: A feasibility study

Cited by 30 publications

References 34 publications

Large Liver Blood Vessels and Bile Ducts Are Not Damaged by Electrochemotherapy with Bleomycin in Pigs

Large Liver Blood Vessels and Bile Ducts Are Not Damaged by Electrochemotherapy with Bleomycin in Pigs

Irreversible electroporation for hepatic tumors

Clinical impact of irreversible electroporation ablation for unresectable hilar cholangiocarcinoma

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