Abstract No. 322 - Effect of irreversible electroporation (IRE) on liver function tests following treatment of primary and metastatic liver tumors: a single center retrospective analysis

Abstract

Purpose Retrospective evaluation of the effects of IRE on liver function tests (LFT), following treatment of hepatocellular carcinoma (HCC) and metastatic liver tumors. Materials and Methods Between Jan 2010 and Dec 2011, the LFT’s of 60 patients that had 74 IRE treatments in liver with the Nanoknife (angiodynamics, NY) were reviewed. Twenty eight patients had primary HCC and 32 patients had metastatic liver tumors. Age range was between 40-83 years, with a mean of 61 years (males-38, females-22). Total Bilirubin, AST (aspartate aminotransferase), ALT (alanine transaminase) and ALKP (alkaline phosphatase) levels were analyzed at baseline, 24-48 hour and 1-8 weeks post IRE. Wilcoxon signed rank test was performed using the SPSS 20.0 to assess the significance of differences in pre and 24-48 hour post procedure lab values. All lab values were categorized into normal, grade 1, grade 2, grade 3 and grade 4 according to CTCAE criteria 4.03. Results Bilirubin values increased after 54(75%) of 72 procedures (p=0.00) at 24-48 hour post-IRE (mean increase: 0.6 mg/dl, range: 0.1-3.9 mg/dl). In 43 (79.6%) of the 54 procedures with an increase, the bilirubin values still remained in the normal range. Out of 74 procedures, AST values increased significantly in 73 (98.7%) procedures (p=0.00) and exceeded the baseline AST grade in 70 (94.6%) procedures at 24-48 hour post-IRE (mean increase: 553.9 U/L, range: 16-2068 U/L). At 1-8 week follow-up AST values were available for 32 procedures, of which 26 (81.3%) returned to baseline. The ALT values increased significantly in all procedures (p=0.00) and exceeded the baseline grade in 67 (90.5%) procedures at 24-48 hour post-IRE (mean increase: 355 U/L, range: 2-1469 U/L). At 1-8 week time point, ALT values were available for 32 procedures, of which 23 (71.8%) returned to baseline. ALKP values decreased significantly in 57 (77%) of 74 procedures (p=0.00) at 24-48 hour post-IRE (mean decrease 39 U/L, range: 3-140U/L). Conclusion IRE treatments in the liver are associated with transient changes in LFT values that trend back to baseline over 1-8 weeks. Limitations of our study include the retrospective nature and unavailability of some of the values at certain time points.