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World J Gastroenterol. Jun 28, 2020; 26(24): 3421-3431
Published online Jun 28, 2020. doi: 10.3748/wjg.v26.i24.3421
Recent progress in pulsed electric field ablation for liver cancer
Zhen-Guo Liu, Xin-Hua Chen, Zu-Jiang Yu, Jun Lv, Zhi-Gang Ren
Zhen-Guo Liu, Zu-Jiang Yu, Jun Lv, Zhi-Gang Ren, Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Zhen-Guo Liu, Zu-Jiang Yu, Jun Lv, Zhi-Gang Ren, Gene Hospital of Henan Province, Zhengzhou 450052, Henan Province, China
Zhen-Guo Liu, Zu-Jiang Yu, Jun Lv, Zhi-Gang Ren, Precision Medicine Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Xin-Hua Chen, Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Xin-Hua Chen, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Hangzhou 310003, Zhejiang Province, China
Xin-Hua Chen, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China
Author contributions: Ren ZG and Yu ZJ designed the study; Liu ZG, Chen XH, and Lv J collected and analyzed the data; Liu ZG and Ren ZG wrote the manuscript. All authors reviewed and approved the manuscript.
Supported by the National Science and Technology Major Project of China, No. 2018ZX10301201 and No. 2017ZX10302201; National Key Research and Development Program of China, No. 2018YFC2000500.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Gang Ren, MD, PhD, Academic Research, Assistant Professor, Doctor, Department of Infectious Diseases, the First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe East Road, Zhengzhou 450052, Henan Province, China. fccrenzg@zzu.edu.cn
Received: March 11, 2020
Peer-review started: March 11, 2020
First decision: April 25, 2020
Revised: May 6, 2020
Accepted: May 29, 2020
Article in press: May 29, 2020
Published online: June 28, 2020
Abstract

The number of liver cancer patients is likely to continue to increase in the coming decades due to the aging of the population and changing risk factors. Traditional treatments cannot meet the needs of all patients. New treatment methods evolved from pulsed electric field ablation are expected to lead to breakthroughs in the treatment of liver cancer. This paper reviews the safety and efficacy of irreversible electroporation in clinical studies, the methods to detect and evaluate its ablation effect, the improvements in equipment and its antitumor effect, and animal and clinical trials on electrochemotherapy. We also summarize studies on the most novel nanosecond pulsed electric field ablation techniques in vitro and in vivo. These research results are certain to promote the progress of pulsed electric field in the treatment of liver cancer.

Keywords: Hepatocellular carcinoma, Pulsed electric field, Irreversible electroporation, Electrochemotherapy, Nanosecond pulsed electric fields, Ablation treatment

Core tip: The economic burden of liver cancer worldwide remains great. As a new therapeutic method, pulsed electric field ablation has revolutionized the treatment of liver cancer since this method is different from traditional thermal ablation. We focus on the safety of irreversible electroporation in the clinical treatment of liver cancer and the evaluation of imaging technology. We also review preclinical studies of electrochemotherapy and nanosecond pulsed electric field for liver cancer.