A study recently published in the Journal of the American College of Surgeons shows promising results in the treatment of liver tumours adjacent to blood vessels with the NanoKnife System (AngioDynamics).
Peter Kingham, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, USA and colleagues, made a retrospective review of patients treated with the NanoKnife System between 1 January and 2 November 2011. Twenty-eight patients had 65 tumors treated that were near blood vessels. Median tumor size was 1cm.
Post-operative imaging was used to assess the state of blood vessels adjacent to tumors treated with the system. All blood vessels were judged healthy. A single post-procedure vessel occlusion occurred in one of the tumors. This patient had a history of metastatic colorectal cancer and multiple liver resections previously.
At an average follow-up of six months, 96% of patients were without persistent disease and 95% of tumors had not recurred locally.
Before having a procedure, all patients had locally advanced pain with a median pain score of five on a scale of three to nine and were taking a median dose of 75 mcg of a narcotic per day. At 90-days follow-up the average narcotic use was 25 mcg per day, with an average pain score of three. Complications included one intra-operative arrhythmia and one post-operative portal vein thrombosis. Overall morbidity was 3%. There were no treatment-associated mortalities.
The authors concluded that their early analysis of the NanoKnife System demonstrated safety for treating liver malignancies adjacent to blood vessels, potentially expanding therapeutic options for physicians in previously challenging areas. They further concluded that larger studies and longer follow-ups are necessary to determine long-term efficacy.
In the United States, the NanoKnife System has been cleared by the FDA for use in the surgical ablation of soft tissue. The NanoKnife System has not been cleared for the treatment or therapy of a specific disease or condition.