Abstract
Irreversible electroporation (IRE) has recently gained in popularity as an ablative technique, however little is known about its oncological long-term outcomes. To determine the long-time survival of animals treated with a high dose of IRE and which histological changes it induces in tumoral tissue, IRE ablation was performed in forty-six athymic-nude mice with KM12C tumors implanted in the liver by applying electric current with different voltages (2000 V/cm, 1000 V/cm). The tumors were allowed to continue to grow until the animals reached the end-point criteria. Histology was harvested and the extent of tumor necrosis was semi-quantitatively assessed. IRE treatment with the 2000 V/cm protocol significantly prolonged median mouse survival from 74.3 ± 6.9 days in the sham group to 112.5 ± 15.2 days in the 2000 V/cm group. No differences were observed between the mean survival of the 1000 V/cm and the sham group (83.2 ± 16.4 days, p = 0.62). Histology revealed 63.05% ± 23.12 of tumor necrosis in animals of the 2000 V/cm group as compared to 17.50% ± 2.50 in the 1000 V/cm group and 25.6% ± 22.1 in the Sham group (p = 0.001). IRE prolonged the survival of animals treated with the highest electric field (2000 V/cm). The animals in this group showed significantly higher rate of tumoral necrosis.
Highlights
In recent years, a number of clinical studies have addressed the advantages of Irreversible electroporation (IRE) in tumor ablations next to the portal/hepatic veins, major bile ducts and large vessels, avoiding the technical limitations of the thermal modalities[10,11,12,13,14]
In the subsequent regression analyses they concluded that a tumor volume > 5 cm[3] and underlying disease type present in the patients were factors independently associated with early local recurrence[18,19]
Irreversible electroporation prolongs the overall survival of mice with liver tumors and reduces tumor growth rate
Summary
A number of clinical studies have addressed the advantages of IRE in tumor ablations next to the portal/hepatic veins, major bile ducts and large vessels, avoiding the technical limitations of the thermal modalities[10,11,12,13,14]. Animal models are needed to clarify the histological changes experienced in ablated tumors after a long follow-up. In clinical practice these changes are extremely difficult to assess, as recurrences are normally evaluated by imaging diagnostic with MRI or CT. These methods approximate the grade of response by assessing the regression of the tumor size but there is often a poorly delineated ablation zone caused by a periablational inflammatory tissue, which decreases the accuracy of the calculated volumes, especially on CT20. An additional aim was to assess the specific histological response of electroporated tumors at this point, by quantifying the grade of tumoral necrosis and the residual viable tumor
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