Treating Cancer with Percutaneous Ablation

Cancer is a global scourge. It is estimated that 1 in 5 men and 1 in 6 women will develop cancer during their lifetime*. But it's not hopeless. Significant progress has been made in recent years regarding cancer prevention, detection, and diagnosis, and the curative field shows promise. This is precisely where Quantum Surgical comes in. * Source Globocan

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What is interventional oncology?

Over the past decades, several cancer treatments have been developed including chemotherapy, radiotherapy, surgery, and sometimes less known, interventional procedures. The choice of the treatment option and combination are critical and depends on the tumor type, cancer stage, and multiple clinical parameters which an oncologist will assess.

Chemotherapy

Chemotherapy uses drugs to kill or slow the growth of cancer cells. It is a systemic treatment that can reach cancer cells throughout the body, making it suitable for treating cancers that have spread (metastasized). Chemotherapy is commonly used for a wide range of cancers and may be administered before or after surgery.

Radiotherapy

Radiation therapy uses high-energy beams to target and destroy cancer cells. It is often used to shrink tumors, alleviate symptoms, and prevent cancer from recurring. Radiation therapy can be delivered externally (external beam radiation) or internally (brachytherapy) depending on the cancer type and location.

Surgery

Surgery involves the removal of the cancerous tumor and surrounding tissues. It is often used to treat localised cancers and can be curative in some cases. The goal of surgery is to eliminate as much of the cancer as possible while preserving healthy tissue and organs.

Interventional oncology

Interventional oncology (IO) focuses on the use of minimally invasive, image-guided procedures to diagnose, treat, and manage various types of cancer. Interventional oncologists are trained physicians who use advanced imaging techniques, such as ultrasound, CT scans, MRI, and fluoroscopy, to guide their procedures and precisely target tumors and cancerous tissues.
Interventional oncology procedures are generally less invasive than traditional surgery and can be performed on an outpatient or day-surgery basis. They offer several advantages, including reduced post-operative pain, shorter recovery times, and minimal damage to healthy tissues surrounding the tumor.

What is percutaneous ablation?

Percutaneous ablation is a minimally-invasive technique used in interventional oncology as an alternative to surgery. It involves the insertion of a thin needle or probe through the skin (percutaneously) and into the targeted area to destroy or remove the tumor. These procedures are performed by interventional radiologists under imaging guidance, typically with CT-scan or ultrasound, to precisely guide the needle to the tumor site.

Types of percutaneous ablation

There are several types of ablation. The specific technique chosen can depend on multiple factors, including the size, location, and type of cancer.

Radiofrequency ablation (RFA) generates heat with radiofrequency waves to destroy cancerous or abnormal tissue.

Microwave ablation (MWA) generates heat with microwave energy to destroy cancerous or abnormal tissue. This technique can be more effective in larger tumors and has a faster treatment time compared to RFA.

Cryoablation (Cryo) uses extreme cold that rapidly cools the surrounding tissues, leading to the formation of an ice ball that will damage and kill the cells.

Irreversible Electroporation (IRE) involves the application of short, intense electric pulses to the target tissue to destroy the cancer cells.

Benefits of percutaneous ablation

Since percutaneous ablation is an alternative to surgery, it can offer many benefits to patients:

Very small tumors can be treated even at an early stage
Treatment is better targeted, leading to minimal damage to healthy tissues surrounding the tumor
Treatment is less invasive, thus more comfortable for the patient
Pain is reduced
Patient recovery time is shorter
Procedure can be outpatient, requiring shorter hospitalization
May be a treatment option for patients not eligible for surgery

Why is percutaneous ablation underutilized?

Percutaneous ablation is underutilized as a first-line treatment for cancer patients due to several compounding issues:

Procedural complexity^1,2

Ablation procedures can be difficult to confidently execute, even for the most skilled interventional oncologists. The workflow is complex and disparate, utilizing multiple pieces of equipment. It is also an iterative and time consuming process to accurately place ablation needles..

Skilled physician shortage^3,4

With a steep learning curve taking significant time to mastery, there are a limited number of interventional oncologists able to perform ablation procedures. Because of this, public awareness of percutaneous ablation and interventional oncology is relatively low.

Limited patient qualification^4,5,6

Not all cancer patients are candidates for ablation procedures. The size and location of the tumor may be disqualifying factors. Referring physicians may also not be aware of ablation as a viable option for treatment for their patients.

Limited hospital resources^7,8

Lengthy and unpredictable procedure times can make scheduling a challenge for hospitals, especially with limited CT-suite availability. Increased radiation exposure for physicians may also limit the frequency of procedures.

A patient's story

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The need for minimally invasive ablation treatment is profound

With cancer diagnostic rates on the rise, treating an influx of patients is a challenge for hospitals. Robotic-assisted percutaneous ablation can provide an efficient and effective first-line treatment option for these patients.

Lungs

2,480,675 new cases in 2022
#1 cancer diagnosis
1,817,469 deaths - #1 death cause
Smoking

Liver

866,136 new cases in 2022
#6 Cancer diagnosis
758,725 deaths - #3 deathliest cancer
Obesity, alcohol, smoking

Pancreas

510,992 new cases in 2022
#12 Cancer diagnosis
467,409 deaths - #6 deadliest cancer
Obesity, alcohol, smoking

Kidneys

434,840 new cases in 2022
#14 cancer diagnosis
155,953 deaths - #16 deadliest cause
Obesity, alcohol, smoking

Where to find Epione

Questions? Answers.

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If you can't find the answer to your question, please contact us.

What are the deadliest cancers?

Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, or nearly one in six deaths. The most common causes of cancer death in 2020 were:
• lung (1.80 million deaths);
• colon and rectum (916 000 deaths);
• stomach (769 000 deaths);
• and breast (685 000 deaths).

What type of cancer can be treated with Epione?

Epione^® can be used to treat liver, kidneys, pancreas and lung tumors. And specifically, early-stage, hard to reach tumors. A clinical study has been launched in September 2024 to assess Epione’s performance to treat bone tumors and metastasis.

What are the benefits of percutaneous ablation for patients?

Percutaneous ablation is a great alternative to surgery and offer many benefits to patients:
• Very small tumors can be treated even at an early stage
• The treatment is better targeted and therefore leads to minimal damage to healthy tissues surrounding the tumor
• The treatment is less invasive
• The pain is reduced
• The recovery time is shorter for patients and a shorter time hospitalization
• Procedure can be outpatient and more easy
• Can treat patients who have not been eligible for surgery

1. U.S. Food and Drug Administration. 510(k) Summary for Epione. Silver Spring, MD: FDA; 2023. K223758.
2. TÜV Rheinland (August 31, 2021). MDR Ann. IX, Chapt I Certificate (Certificate No. HZ 1551912-1). Quantum Surgical SAS. [https://www.certipedia.com/certificates/HZ+1551912-1].
3. Najafi G, Kreiser K, Abdelaziz MEMK, Hamady MS. Current State of Robotics in Interventional Radiology. Cardiovasc Intervent Radiol. 2023;46(5):549-561. doi:10.1007/s00270-023-03421-1.
4. Charalampopoulos G, Bale R, Filippiadis D, Odisio BC, Wood B, Solbiati L. Navigation and Robotics in Interventional Oncology: Current Status and Future Roadmap. Diagnostics (Basel). 2023;14(1):98. Published 2023 Dec 31. doi:10.3390/diagnostics14010098.
5. Bodard S, Guinebert S, Dimopoulos PM, Tacher V, Cornelis FH. Contribution and advances of robotics in percutaneous oncological interventional radiology. Bull Cancer. 2024. doi:10.1016/j. bulcan.2024.06.004.
6. Moschovas MC, Bravi CA, Dell’Oglio P, et al. Current practice and unmet training needs in robotic-assisted radical prostatectomy: investigation from the Junior ERUS/YAU working group. World J Urol. 2024;42(1):59. Published 2024 Jan 27. doi:10.1007/s00345-023-04713-4.
7. Ayabe RI, Azimuddin A, Tran Cao HS. Robot-assisted liver resection: the real benefit so far. Langenbecks Arch Surg. 2022;407(5):1779-1787. doi:10.1007/s00423-022-02523-7.
8. Vernuccio F, Messina C, Merz V, Cannella R, Midiri M. Resectable and Borderline Resectable Pancreatic Ductal Adenocarcinoma: Role of the Radiologist and Oncologist in the Era of Precision Medicine. Diagnostics (Basel). 2021;11(11):2166. Published 2021 Nov 22.
doi:10.3390/diagnostics11112166.

The future of minimally invasive cancer treatment is today.

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