BACKGROUND:The available ablative procedures for the treatment of hepatic cancer have contraindications due to the heat-sink effect and the risk of thermal injuries. Electrochemotherapy (ECT) as a nonthermal approach may be utilized for the treatment of tumors adjacent to high-risk regions. We evaluated the effectiveness of ECT in a rat model.METHODS:WAG/Rij rats were randomized to four groups and underwent ECT, reversible electroporation (rEP), or intravenous injection of bleomycin (BLM) eight days after subcapsular hepatic tumor implantation. The fourth group served as Sham. Tumor volume and oxygenation were measured before and five days after the treatment using ultrasound and photoacoustic imaging; thereafter, liver and tumor tissue were additionally analysed by histology and immunohistochemistry.RESULTS:The ECT group showed a stronger reduction in tumor oxygenation compared to the rEP and BLM groups; moreover, ECT-treated tumors exhibited the lowest levels of hemoglobin concentration compared to the other groups. Histological analyses further revealed a significantly increased tumor necrosis of >85% and a reduced tumor vascularization in the ECT group compared to the rEP, BLM, and Sham groups.CONCLUSION:ECT is an effective approach for the treatment of hepatic tumors with necrosis rates >85% five days following treatment.

Insgesamt sind Gallengangs- und Gallenblasenkarzinome seltene Erkrankungen. Die Diagnostik dieser cholangiogenen Karzinome ist bisweilen eine Herausforderung, und allen Tumorentitäten ist gemeinsam, dass die R0-Tumorresektion den einzig kurativen Therapieansatz darstellt. Die Beurteilung der Resektabilität erfordert umfassende hepatobiliäre chirurgische Expertise und sollte daher nur in entsprechenden Zentren erfolgen.

Introduction Only around 20% of patients are diagnosed with a primarily resectable pancreatic ductal adenocarcinoma. However, some of these patients show intraoperatively the incidental finding of a solitary, resectable liver metastasis (LM). Another 15- 20% of tumors are locally- advanced or involving surrounding organs at diagnosis. The objective of this study was to investigate first if the long- term survival of these patients can be improved by an extended resection (ER) and second to point out the strongest predictors for long- term survival. Patients and methods All patients with locally- advanced tumors or those with intraoperatively diagnosed, unexpected, solitary LM between January 2002 and December 2013 were analyzed retrospectively. The ER was defined as the simultaneous resection of adjacent organs or solitary LM. For statistical analyses, these patients´ long- term survival was compared with the one of patients who did not undergo oncological tumor resection in case of locally- advanced cancer. Results 40 patients (17 men, 23 women, age 68 ± 9.5 years) underwent ER and another 40 patient’s only explorative laparotomy or palliative surgical treatment. After ER, patients had a significantly better longterm survival (10.8 ± 2.85 vs. 6.43 ± 2.43 months, p=0.02). The R0- resection and the application of a postoperative chemotherapy were the strongest predictors for long- term survival. Conclusion In case of locally- advanced ductal pancreatic adenocarcinoma or intraoperatively diagnosed, unexpected, solitary LM, selected patients can benefit from an extended resection in order to achieve clearness of tumor. The R0- resection and the use of postoperative chemotherapy are the strongest predictors for long- term survival.