PERCUTANEOUS ELECTROCHEMOTHERAPY IN PRIMARY AND SECONDARY LIVER MALIGNANCIES – LOCAL TUMOUR CONTROL AND IMPACT ON OVERALL SURVIVAL

ECT IN LIVER MALIGNANCIES

Abstract

Background. Local non-surgical tumour ablation represents nowadays a further option for the treatment of patients with liver tumours or metastases. Electrochemotherapy (ECT) is a welcome addition to the portfolio of local therapies. A retrospective analysis of patients with liver tumours or metastases treated with ECT is reported. Attention is paid to safety and efficacy of the treatment over time.

Patients and methods. Eighteen consecutive patients have been recruited with measurable liver tumours from different histopatologic origin, mainly colorectal cancer, breast cancer, hepatocellular cancer. They have been treated with percutaneous ECT following the SOP (Standard Operating Procedures) for ECT, under general anaesthesia and muscle relaxation. Treatment planning was performed based on MRI pre-operative images. The follow-up assessment included a magnetic resonance with hepatospecific contrast agent within at least 1-3 months after treatment, and then after 5, 7, 9, 12, 18 months, until progression of the disease or death.

Results. Only mild or moderate side effects were observed after ECT. Objective response rate was 85.7% (complete response 61.9%, partial 23.8%), mean progression-free survival (PFS) was 9.0±8.2 months, overall survival (OS) 11.3±8.6 months. ECT performs best (PFS and OS) in lesions within 3 and 6 cm diameter (p=0.0242, p=0.0297). The effectiveness of ECT is independent of the localization of the lesions: distant, close or adjacent to vital structures. Progression free survival and overall survival are independent of primary histology considered.

Conclusions. Electrochemotherapy provides an effective valuable option for the treatment of unresectable liver metastases not amenable to other ablative techniques.