Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors

Aim of this retrospective analysis was to evaluate the survival times after percutaneous irreversible electroporation (IRE) in inoperable liver tumors not amenable to thermal ablation. 71 patients (14 females, 57 males, median age 63.5 ± 10.8 years) with 103 liver tumors were treated in 83 interventions using IRE (NanoKnife® system). The median tumor short-axis diameter was 1.9 cm (minimum 0.4 cm, maximum 4.5 cm). 35 patients had primary liver tumors and 36 patients had liver metastases. The Kaplan-Meier method was employed to calculate the survival rates, and the different groups were compared using multivariate log-rank and Wilcoxon tests. The overall median survival time was 26.3 months; the median survival of patients with primary land secondary liver cancer did not significantly differ (26.8 vs. 19.9 months; p = 0.41). Patients with a tumor diameter >3 cm (p < 0.001) or more than 2 lesions (p < 0.005) died significantly earlier than patients with smaller or fewer tumors. Patients with hepatocellular carcinoma and Child-Pugh class B or C cirrhosis died significantly earlier than patients with Child-Pugh class A (p < 0.05). Patients with very early stage HCC survived significantly longer than patients with early stage HCC with a median survival of 22.3 vs. 13.7 months (p < 0.05).

Percutaneous irreversible electroporation (IRE) of prostate cancer: Contrast-enhanced ultrasound (CEUS) findings

PURPOSE

To evaluate the use of contrast-enhanced ultrasound (CEUS) after irreversible electroporation (IRE) of prostatic cancer tissue to assess the ablation status by depicting microvascularisation in the ablation area.

MATERIALS AND METHODS

Retrospective evaluation of CEUS of 13 patients (mean age: 61.4 ± 7.5 years) with histologically confirmed prostatic cancer who underwent percutaneous IRE. In the course of clinical routine, the tumor lesions were documented before, immediately after, and 1 day after the ablationusing color-coded transabdominal and transrectal CEUS. The obtained image data (DICOM loops and images) were subsequently evaluated by 2 experienced radiologists and assessed with regard to micro vascularisation by means of a 5-point scale.

RESULTS

CEUS images showed significantly reduced microcirculation of the lesions (mean 0.9 ± 0.6 cm (0.5-1.5 cm) after IRE. Microcirculation was reduced from 2.15 ± 0.56 prior to ablation to 0.65 ± 0.63 (p <  0.001) immediately after the ablation and to 0.27 ± 0.44 one day after IRE (p <  0.001).

CONCLUSION

This study showed rapid and significant reduction of the microcirculation in the ablation area afterpercutaneous IRE of prostatic cancer tissue.

[Management of solid pulmonary nodules]

The increasing availability of computed tomography has meant that the number of incidentally detected solitary pulmonary nodules (SPN) has greatly increased in recent years. A reasonable management of these SPN is necessary in order to firstly be able to detect malignant lesions early on and secondly to avoid upsetting the patient unnecessarily or carrying out further stressful diagnostic procedures. This review article shows how the dignity of SPNs can be estimated and based on this how the management can be accomplished taking established guidelines into consideration.

Vierzähnige Benzamidin-Liganden in ein-und mehrkemigen Kupfer(II)-Komplexen / Quadridentate Benzamidine Ligands in Mono-and Oligonuclear Copper(II) Complexes

Bridged N-thiocarbamoyl substituted bis-benzamidines (C2H5)2N-C(S)-N=C(Ph)-NH-R-NH-C(Ph)=N-C(S)-N(C2H5)2 with different moieties R (H2L1 : R = diphenylmethane-2,2'-diyl, H2 L2: R = diphenylmethane-3,3'-diyl, and H2L3: R = diphenylmethane-4,4'-diyl) were synthe­sized by the reaction of N-(thiocarbamoyl)benzimidoyl chlorides with diamines. These quadri­ dentate ligands form neutral mononuclear (CuL1), dinuclear (Cu2L3 2) and trinuclear (Cu3L2 3) copper(II) chelates in dependence of the different bridging unit in the ligands. The compounds were characterized by NMR, IR, EPR and XPS spectroscopy and FAB mass spectrometry. The molecular structures of the ligand H2L3 and the complex CuL1 have been determined by X-ray methods.

Labilisierung einer Carboxylgruppe der koordinierten Triethylentetramin- N, N, N′,N″, N‴, N‴ -hexaessigsäure (H6ttha): Koordinationszahlen 10 für [La(H ttha)]2- und 9 für [Dy(Httha)]2- in ihren Guanidiniumsalzen / Labilizing of a Carboxyl Group o f the Coordinated Triethylenetetramine-N, N, N′ ,N″, N‴, N‴ - hexaacetic Acid (H6ttha): Coordination Numbers 10 for [La(Httha)]2- and 9 for [Dy(Httha)]2- in their Guanidinium Salts

The lanthanum(III) and dysprosium(III) complexes of triethylenetetramine-N, N, N′, N″, N‴, N‴-hexaacetic acid (H6ttha) were prepared and isolated as guanidinium salts:[C(NH2)3]2[La(Httha)] · 3 H2O and [C(NH2)3]2[Dy(Httha)] · 5 H2O. The X-ray crystal structure of both complexes was determined: In the La(III) complex (space group P1̄) all donor atoms (N4O6) are coordinated. The coordination number 10 is realized in a bicapped square antiprism (SAPRS-10). The bond length La to O of the protonated carboxylic group is ca. 0.3 Å longer than the other five La-O distances. The Dy(III) complex (space group P1̄) exhibits coordination number 9 in a monocapped square antiprism (SAPRS-9). The protonated carboxylic group is not coordinated.