Irreversible electroporation for primary liver cancer

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 11 sources, which was discussed by the committee. The evidence included 3 non-randomised comparative studies (1 of which was a conference abstract included for safety data only), 7 case series and 1 case report. It is presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.

The specialist advisers and the committee considered the key efficacy outcomes to be: tumour ablation, progression-free survival, overall survival and quality of life.

The specialist advisers and the committee considered the key safety outcomes to be: damage to adjacent structures, bleeding, cardiac arrhythmias and tumour seeding.

Patient commentary was sought but none was received.

The committee was informed that the procedure may have a particular role for small tumours (that is, under 3 cm) next to blood vessels or the biliary tree, which may not be suitable for ablation by other techniques.

The committee was informed that the positioning and alignment of needles is critical to the success of the procedure.