Introduction: The use of irreversible electroporation (IRE) is a fairly recent innovation in the surgical management of oncologic disease with promising results. This ablative technique proposes the ability to locally manage solid neoplasms with definable tissue selectivity and the absence of thermal necrosis and its sequelae. We incorporated intra-operative IRE in the treatment of solid tumors, attempting to achieve local control in close R1 resections. This study evaluates IRE in the treatment of non-pancreatic and non-hepatic cancers and to assess its utility in margin enhancement.

Methods: This is a retrospective chart review of a prospective database at a single tertiary institution. Included were patients with cancer undergoing IRE from November 2013 through May 2016 at time of surgical resection of primary or metastatic tumors for margin enhancement.

Results: 17 patients received intraoperative IRE for margin enhancement of non-hepatic and non-pancreatic lesions. 9 (57.9%) had no recurrence, 2 (11.8%) had local recurrence, and 6 (35.3%) experienced distant recurrence. 2 (11.8%) reported nerve palsies/parasthesias possibly attributable to IRE, though also known complications of the resection.

Conclusions: We report a local recurrence rate of only 11.8% in patients treated with intra-operative IRE and demonstrated no intra-operative complications. Intra-operative IRE was not associated with unplanned re-interventions or readmissions within the global 30-day post-operative period. We propose that intra-operative IRE may be a viable and safe adjunct in the surgical management of non-pancreatic and non-hepatic cancers in attaining clinically R1 resection margins. This contention would benefit from extensive patient follow-up and investigation of prospective data.