Clinical effect of ablation in treatment of needle tract implantation after radiofrequency ablation for primary liver cancer / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the risk factors for needle tract implantation after radiofrequency ablation for primary liver cancer and the clinical effect of ablation. MethodsA retrospective analysis was performed for the clinical data of 4 patients with needle tract implantation after radiofrequency ablation for primary liver cancer who underwent ablation therapy in Center of Interventional Oncology and Liver Diseases, Beijing YouAn Hospital, from January 2017 to October 2018. Risk factors, the clinical effect of ablation, and complications were analyzed. ResultsAll four patients had intrahepatic tumor lesions located near the Glisson′s capsule, and among these patients, two had poorly differentiated hepatocellular carcinoma (HCC), one had moderately differentiated HCC, and one had well-differentiated HCC. The time from radiofrequency ablation to needle tract implantation ranged from 3.6 to 14.3 months, and all four patients had a single lesion of needle tract implantation, which was located at the anterior abdominal wall in three patients and at the right abdominal wall in one patient. Of all patients, three underwent argon-helium cryoablation, and one underwent radiofrequency ablation. Two patients experienced pyrexia and transient aggravation of pain after surgery, and the symptoms were relieved after symptomatic treatment. No serious complication was observed. Contrast-enhanced computed tomography performed at one month after surgery showed complete ablation of metastatic lesion in three patients, with no recurrence after follow-up for 2-19 months. One patient was found to have local residual lesion, with marked relief of pain, and no enlargement of the residual lesion was observed after follow-up for 3 months. All patients had significant reductions in serum alpha-fetoprotein and abnormal prothrombin at one month after surgery. ConclusionAblation therapy, especially argon-helium cryoablation, has a good clinical effect in the treatment of needle tract implantation at the abdominal wall, with the advantages of few complications and good tolerability. Therefore, it is a good choice for patients who cannot tolerate surgical operation or are unwilling to undergo surgical operation.