 |
Case Report
Percutaneous irreversible electroporation in combination with radiofrequency ablation in the treatment of non-resectable hepatocellular carcinoma: A case report
1 Department of Cardiac Surgery and Transplantation, Section of Clinical Ecointervention, Monaldi Hospital, AORN Ospedali dei Colli, Piazzale Ettore Ruggieri snc, Naples, Italy
2 Department of Critical Care Area, Unit of Anesthesia and Intensive Care, Monaldi Hospital, AORN Ospedali dei Colli, Piazzale Ettore Ruggieri snc, Naples, Italy
Address correspondence to:
Enrico Ragone
MD, Department of Cardiac Surgery and Transplantation, Chief of Section of Clinical Ecointervention, Monaldi Hospital, AORN Ospedali dei Colli, Piazzale Ettore Ruggieri snc, 80131, Naples,
Italy
Message to Corresponding Author
Article ID: 100055Z06SS2018
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Scarica S, Sanges F, Giuseppe R, Ragone E. Percutaneous irreversible electroporation in combination with radiofrequency ablation in the treatment of non-resectable hepatocellular carcinoma: A case report. Case Rep Int 2018;7:100055Z06SS2018.ABSTRACT
Introduction: There are more option of treatments of hepatocellular carcinoma (HCC), that is currently the sixth most common cancer worldwide. As only 10–20% of patients are candidates for surgery (resection or transplantation), ablative therapies such as Radiofrequency (RF) and Microwave (MW) ablation are both widely used techniques, but tumors adjacent to heat-sensitive structures such as the gallbladder, major bile ducts, portal vein, and hepatic veins are difficult to destroy. Irreversible electroporation (IRE) is a new non-thermal ablation technique for pancreatic and liver tumors that generates electrical fields leading to cell death through apoptosis. In this way IRE prevents collateral damage to other tissues, such as blood vessels, bile ducts, nerves, gallbladder and other vital organs which often occur in thermal ablation techniques.
Case Report: We report the treatment of an inoperable HCC with a maximum diameter of 40 mm in left lobe at the 4th hepatic segment, adjacent to the gallbladder in a 75-year-old female with hepatitis C–related cirrhosis. It was used for the first time a dual thermal and nonthermal ablative technique: ultrasound–guided irreversible electroporation ablation (IRE) following ultrasound–guided radiofrequency ablation (RFA) in the same session. We got complete response at 1, 3 and 6 months follow-up without evidenced of local tumor progression or metastatic disease.
Conclusion: Combination therapy plays an important role in the treatment of unresectable HCC, because near vital structures, but additional research is necessary to assess further the safety, efficacy and long-term outcomes for this combination therapy.
Keywords: Hepatocellular carcinoma, Irreversible electroporation, Non-resectable hepatocellular carcinoma, Radiofrequency ablation
SUPPORTING INFORMATION
Author Contributions
Sabrina Scarica - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Federica Sanges - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Giuseppe Rossi - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Enrico Ragone - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2018 Sabrina Scarica et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
