Percutaneous electrochemotherapy in primary and secondary liver malignancies – local tumor control and impact on overall survival

Abstract

Background Local nonsurgical tumor ablation currently represents a further option for the treatment of patients with liver tumors or metastases. Electrochemotherapy (ECT) is a welcome addition to the portfolio of local therapies. A retrospective analysis of patients with liver tumors or metastases treated with ECT is reported. Attention is given to the safety and efficacy of the treatment over time. Patients and methods Eighteen consecutive patients were recruited with measurable liver tumors of different histopatologic origins, mainly colorectal cancer, breast cancer, and hepatocellular cancer. They were treated with percutaneous ECT following the standard operating procedures (SOP) for ECT under general anaesthesia and muscle relaxation. Treatment planning was performed based on MRI preoperative images. The follow-up assessment included contrast-enhanced MR within at least 1–3 months after treatment and then after 5, 7, 9, 12, and 18 months until progression of the disease or death. Results Only mild or moderate side effects were observed after ECT. The objective response rate was 85.7% (complete response 61.9%, partial 23.8%), the mean progression-free survival (PFS) was 9.0 ± 8.2 months, and the overall survival (OS) was 11.3 ± 8.6 months. ECT performed best (PFS and OS) in lesions within 3 and 6 cm diameters (p = 0.0242, p = 0.0297) . The effectiveness of ECT was independent of the localization of the lesions: distant, close or adjacent to vital structures. Progression-free survival and overall survival were independent of the primary histology considered. Conclusions Electrochemotherapy provides an effective valuable option for the treatment of unresectable liver metastases not amenable to other ablative techniques.

Percutanous Electrochemotherapy (ECT) in Primary and Secondary Liver Malignancies: A Systematic Review

“…In challenging location, the best LTC resulted after RFA (82%) ECT (76%) and IBT (76%). [52] Spalleck et al [53] performed a retrospective analysis of patients with liver tumors or metastases treated with percutaneous ECT. Eighteen consecutive patients with measurable liver tumors of different histopathologic origins, mainly colorectal cancer, breast cancer, and hepatocellular cancer were recruited.…”

“…Papers not indexed in the electronic databases were evaluated through the references of included studies. Eight [44,[47][48][49][50][51][52][53] out of 16 studies were selected. Preclinical studies, review articles and case reports with a single enrolled patient were excluded.…”

Long-Term Comparative Study on the Local Tumour Control of Different Ablation Technologies in Primary and Secondary Liver Malignancies

“…The targeted increase in cytotoxic effect (for BLM in vitro by a factor of 700) is achieved by EP [ 2 ]. The feasibility and safety of percutaneous ECT in hepatic malignancies has been demonstrated [ 17 ]. In patients with HCC, BLM-ECT achieved a complete response in 88.2% per lesion, and in patients with unresectable colorectal liver metastases in 85%.…”

Treatment of vulvar cancer recurrences with electrochemotherapy – a detailed analysis of possible causes for unsuccessful treatment

“…5,6 It can also be utilized for the treatment of deep-seated tumors such as primary hepatocellular carcinoma, colorectal cancer, unresectable colorectal liver metastases or pancreatic carcinoma. [7][8][9][10][11][12] It is conducted following standard operating procedures, and the method is now used in nearly 180 cancer centers around the world. 6 Only a small number of papers describing the use of electrochemotherapy for the palliative treatment of gynecological cancers and mostly vulvar squamous cell carcinoma have been presented.…”