Current practice in the treatment of colorectal liver metastases by irreversible electroporation: An international questionnaire survey (LIVERMET-IRE-Q).

Introduction: Irreversible electroporation (IRE) is a form of non-thermal ablation that delivers pulses of high voltage electrical current between electrodes. Although IRE has been demonstrated to achieve tumour necrosis, its role in the treatment of colorectal hepatic metastases is unestablished. This study is an international questionnaire survey on the use of IRE for patients with colorectal hepatic metastases.

Methods: A questionnaire addressing views on the use of IRE for colorectal liver metastases was circulated to clinicians with an interest and/or expertise in this technique. The questionnaire addressed indications for use of IRE in a range of scenarios, methods of use, assessment of treatment response and outcome.

Results: 64 clinicians from 17 different countries replied to the questionnaire. The preferred mode of delivery of IRE was percutaneous treatment under CT guidance. Thirty-three (70% of 47 respondents) used IRE exclusively for lesions in proximity to inflow or outflow structures. Twenty (43% respondents) used IRE as their sole ablative treatment whilst 19 (40% of 47 respondents) used IRE in combination with thermal ablation. The maximum number of lesions that could be treated by IRE was two and preferred size of lesion was <3 cm.

Conclusion: Respondents to this international questionnaire survey indicate that IRE is an acceptable ablative option for small colorectal liver metastases (< 3 m in diameter) close to inflow/outflow structures.