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Niessen C, Thumann S, Beyer L, Pregler B, Kramer J, Lang S, Teufel A, Jung EM, Stroszczynski C, Wiggermann P. Percutaneous Irreversible Electroporation: Long-term survival analysis of 71 patients with inoperable malignant hepatic tumors. Sci Rep 2017; 7:43687. [PMID: 28266600 PMCID: PMC5339813 DOI: 10.1038/srep43687] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/30/2017] [Indexed: 12/18/2022] Open
Abstract
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).
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Affiliation(s)
- C. Niessen
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - S. Thumann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - L. Beyer
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - B. Pregler
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - J. Kramer
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - S. Lang
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - A. Teufel
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - E. M. Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - C. Stroszczynski
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
| | - P. Wiggermann
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Yang W, Cui M, Lee J, Gong W, Wang S, Fu J, Wu G, Yan K. Heat shock protein inhibitor, quercetin, as a novel adjuvant agent to improve radiofrequency ablation-induced tumor destruction and its molecular mechanism. Chin J Cancer Res 2016; 28:19-28. [PMID: 27041924 DOI: 10.3978/j.issn.1000-9604.2016.02.06] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND We investigated the effect of a small molecular inhibitor of heat shock protein (HSP), quercetin, on tumor radiofrequency (RF) ablation, and explored the underlying molecular mechanisms. METHODS In in vivo study, rats with R3230 breast adenocarcinoma were sacrificed 24 h post-treatment and gross coagulation areas were compared, and next, randomized into four treatment arms (control, quercetin alone, RF alone, and combination) for Kaplan-Meier analysis of defined endpoint survival. Then the distribution and expression levels of heat shock protein 70 (HSP70), cleaved caspase-3 and heat shock factor 1 (HSF1) were analyzed after different treatments. In in vitro study, we used quercetin to promote SK-HEP-1 (hepatic) and MCF-7 (breast) cancer cell apoptosis in heat shock cell model, and siRNA was used to block c-Jun and to explore the role of activating protein-1 (AP-1) signaling pathways. RESULTS We found the effects of quercetin plus RFA resulted in increase on the tumor destruction/endpoint survival (26.5±3.4 d) in vivo, compared with RF alone (17.6±2.5 d) and quercetin alone (15.7±3.1 d). Most importantly, quercetin-induced cancer cell death required the presence of HSF1 in animal model. Furthermore, quercetin directly down-regulated expression of HSF1 in vitro, which our findings have revealed, required the activation of AP-1 signaling pathways by loss-of-function analysis using siRNA mediated targeting of c-Jun. CONCLUSIONS These results indicated a protective role of quercetin in tumor ablation and highlighted a novel mechanism involving HSP70 with HSF1 pathway in thermal ablation of solid tumors.
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Affiliation(s)
- Wei Yang
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Ming Cui
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Jungchieh Lee
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Wei Gong
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Song Wang
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Jingjing Fu
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Gongxiong Wu
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
| | - Kun Yan
- 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, 2 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery IV, Peking University Cancer Hospital & Institute, Beijing 100142, China ; 3 State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China ; 4 Department of Cardiovascular and Neurovascular, Guangzhou Medical University, Guangzhou 510182, China ; 5 Department of Oncology, The first Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China
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