Irreversible electroporation for unresectable liver malignancies

Background: Irreversible electroporation (IRE) is a non-thermal ablation technique used for liver tumors that are unresectable due to their proximity to critical structures. This study evaluates outcomes for patients treated with IRE. Methods: We reviewed 19 patients who underwent 22 IRE procedures between July 2015 and February 2024. Tumors were deemed unresectable by a multidisciplinary tumor board because of abutment to hepatic veins or Inferior vena cava (IVC) (n = 10), recurrence near the hilum post-lobectomy (n = 4), portal vein bifurcation involvement (n = 3), or cirrhosis (n = 3). A percutaneous approach was used in 19 of 22 procedures. Results: The median overall survival was 36.8 months (95% CI 28.9, NR). For patients with colorectal liver metastases, median survival was 49 months (46.7, NR). Local recurrence occurred in 7 of 22 cases (32%), with a median recurrence-free survival of 27 months. Complications were rare, with 16/19 (84%) having no 90-day post-procedure complications. Discussion: Our results support IRE as a safe and effective option for managing unresectable liver tumors near critical structures. These outcomes, achieved at a medium-sized center, highlight its feasibility and patient benefits in anatomically challenging cases.