The National Institute of Health and Care Excellence (NICE) has advised that irreversible electroporation for primary liver cancer should only be performed in the context of research.
The recommendation follows a rapid review of the published literature on the efficacy and safety of the procedure, which included evidence from 11 sources, comprising three non-randomised comparative studies (1 of which was a conference abstract included for safety data only), seven case series and one case report.
The NICE committee considered the key efficacy outcomes to be tumour ablation, progression-free survival, overall survival, and quality of life. Key safety outcomes were considered to be damage to adjacent structures, bleeding, cardiac arrhythmias, and tumour seeding.
In new guidance, NICE says the evidence on the safety of irreversible electroporation for primary liver cancer shows serious but infrequent and well-recognised complications. Evidence on its efficacy is inadequate in quantity and quality and therefore, this procedure should only be used in the context of research, the organisation advises.
Where the procedure is being carried out under appropriate criteria, NICE states that patient selection should be carried out by a multidisciplinary team and the procedure should only be performed in specialist centres by clinicians with experience and specific training.