predictive value of thrombocytopenia for bleeding or liver decompensation following percutaneous radiofrequency ablation therapy of hepatocellular carcinoma in patients with liver cirrhosis

ABSTRACT

To assess if thrombocytopenia has a predictive value for bleeding and/or liver decompensation following percutaneous radiofrequency ablation [RFA] therapy of hepatocellular carcinoma [HCC] in patients with liver cirrhosis. 64 consecutive patients with cirrhosis complicated by hepatocellular carcinoma, and associated with mild thrombocytopenia ranged from 37 to 99 x 10[9] platelets/L, and had undergone percutaneous RFA for treatment 86 hccs, were retrospectively studied. Nine possible factors were analyzed for their ability to predict bleeding or liver decompensation using the Cox proportional hazards regression model; Age, sex, Child-Pugh class, etiology of cirrhosis, platelet count, prothrombin activity, number of tumors, maximum size of the tumor, and type of electrode. It was shown that platelet threshold of 37 x 10[9]/L and the other variables were not significant risk factors of bleeding. Statistical [univariante and multivariente] analysis revealed that liver decompensation was clearly linked to prothrombin activity [p = 0,010 and p = 0.006, respectively] and < 63% of prothrombin activity was found to be a significant threshold for the occurrence of liver decompensation [p = 0.003] confirmed by Cox model [p = 0.05] Mild thrombocytopenia > 37 x 109/L is not an independent risk factor of bleeding or liver decompensation after RFA therapy of HCC in patient with cirrhosis. However, in such situation a significant higher risk of liver decompensation followed the procedure was found in cases of prothrombin activity < 63%.Radiofrequency ablation, hepatocellular carcinoma, thrombocytopenia, prothrombin activity, liver cirrhosis RFA= radiofrequency ablation, HCC = hepatocellular carcinoma, US = ultrasonography, CT = computed tomography