Irreversible Electroporation as a Valid Treatment Option for Hepatic Epithelioid Hemangioendothelioma: An International Multicenter Experience.

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Govindarajan Narayanan, Anthony Spano, Nicole T Gentile, Michelle M Shnayder-Adams, Varshana Gurusamy, David M Levi, Breelyn A Wilky, Ronald A Mora, Raihan Noman, Praveen Peddu, Madelon Dijkstra
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Abstract

Purpose: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare tumor with currently no established standard of care. This international multicenter retrospective study assesses the use of percutaneous irreversible electroporation (IRE) as an ablative tool to treat HEHE and provides a clinical overview of the current management and role of IRE in HEHE treatment.

Material and methods: Between 2017 and 2023, 14 patients with 47 HEHE tumors were treated with percutaneous IRE using CT-scan guidance in 23 procedures. Baseline patient and tumor characteristics were evaluated. Primary outcome measures included safety and effectiveness, analyzed using Common Terminology Criteria for Adverse Events (CTCAE) and treatment response by mRECIST criteria. Secondary outcome measures included technical success, post-treatment tumor sizes and length of hospital stay. Technical success was defined as complete ablation with an adequate ablative margin (intentional tumor free ablation margin > 5 mm).

Results: IRE treatment resulted in technical success in all tumors. Following a median follow-up of 15 months, 30 tumors demonstrated a complete response according to mRECIST criteria. The average tumor size pre-treatment was 25.8 mm, accompanied by an average reduction in tumor size by 7.5 mm. In 38 out of 47 tumors, there was no evidence of local recurrence. In nine tumors, residual tumor was present. There were no cases of progressive disease. Median length of hospital stay was one day. Only one grade 3 CTCAE event occurred, a pneumothorax requiring chest tube placement.

Conclusion: The current study provides evidence that IRE is a safe and efficacious minimally invasive treatment option for HEHE.

Abstract Image

将不可逆电穿孔作为肝上皮样血管内皮细胞瘤的有效治疗方案:国际多中心经验。
目的:肝上皮样血管内皮细胞瘤(HEHE)是一种罕见肿瘤,目前尚无既定的治疗标准。这项国际多中心回顾性研究评估了经皮不可逆电穿孔术(IRE)作为消融工具治疗 HEHE 的使用情况,并提供了目前 IRE 在 HEHE 治疗中的管理和作用的临床概况:2017年至2023年期间,在23次手术中,14名患有47个HEHE肿瘤的患者在CT扫描引导下接受了经皮IRE治疗。对患者和肿瘤的基线特征进行了评估。主要结局指标包括安全性和有效性,采用不良事件通用术语标准(CTCAE)进行分析,并采用 mRECIST 标准分析治疗反应。次要结果指标包括技术成功率、治疗后肿瘤大小和住院时间。技术成功的定义是完全消融并有足够的消融边缘(有意的无肿瘤消融边缘大于 5 毫米):结果:所有肿瘤的 IRE 治疗均取得了技术成功。中位随访 15 个月后,根据 mRECIST 标准,30 个肿瘤显示出完全反应。治疗前肿瘤的平均大小为 25.8 毫米,平均缩小了 7.5 毫米。47 个肿瘤中有 38 个没有局部复发的迹象。9个肿瘤有残余肿瘤。没有进展性疾病病例。住院时间中位数为一天。只发生了一起3级CTCAE事件,即气胸,需要放置胸管:目前的研究证明,IRE 是治疗 HEHE 安全有效的微创疗法。
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来源期刊
CiteScore
5.50
自引率
13.80%
发文量
306
审稿时长
3-8 weeks
期刊介绍: CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.
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