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Objective To investigate the incidence and risk factors of liver abscess after radiofrequency ablation (RFA) for liver cancer.Methods A retrospective study was performed on 1 643 patients from January 2000 to June 2016.All the patients were diagnosed with hepatocellular carcinoma (HCC,n =942),cholangiocellular carcinoma (CCC,n =31) or metastatic liver carcinoma (MLC,n=670).Univariate and multiple Logistic regression analysis were used to evaluate the risk factors of liver abscess.Results The incidence of liver abscess after RFA was 0.79％％ (13/1 643).Univariate analysis indicated that the liver abscess was significantly correlated with the history of diabetic mellitus (DM),Child-Pugh level,history of surgery and tumor location (all P＜0.05).Multivariate analysis showed that the history of DM,history of surgery and tumor location were independent risk factors of liver abscess after RFA for liver cancer.Conclusion History of DM,surgery and tumor location are important factors that result in liver abscess after RFA.
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Objective To investigate the value of percutaneous radiofrequency ablation (RFA) in the treatment of large hepatic carcinoma adjacent to diaphragm.Methods Totally 176 patients with larger hepatic carcinoma adjacent to diaphragm (adjacent diaphragm group) and 157 patients with larger hepatic carcinoma not adjacent to the diaphragm (control group) underwent ultrasound-guided percutaneous RFA treatment,and the data of these patients were retrospectively analyzed.The patients,age,gender,the largest diameter of lesions,ablation information,early necrosis rate,recurrence rate,new tumor rate and survival rate were analyzed and compared between the two groups.Results Cases of injection physiological saline below the diaphragm during RFA were significantly higher in adjacent diaphragm group than that in control group (P=0.016).The recurrence rate of adjacent diaphragm group was significantly higher than that of control group (P=0.028).There was no significant difference of patients,age,gender,the largest diameter of lesion,RFA instrument,RFA needles,early necrosis rate,new tumor rate,nor complications rate between the two groups (all P＞0.05).There was no significant difference of the 1-,2-,3-,4-and 5-year survival rate between the two groups (P=0.203).Conclusion Large hepatic carcinoma adjacent to diaphragm is more likely to recur after ultrasound-guided percutaneous RFA.The method of injection physiological saline below diaphragm and other individualized treatment plan and strategy should be used during RFA treatment.
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PURPOSE: To determine the incidence, risk factors and prognosis associated with needle track seeding after percutaneous radiofrequency ablations (RFA) for hepatocellular carcinoma (HCC) with a long-term follow-up. MATERIALS AND METHODS: A total of 741 HCC patients undergoing percutaneous RFA were retrospectively analysed. Mean follow-up interval was 34.3 ± 26.8 months. All seeding neoplasms were diagnosed by imaging modalities with or without pathological evaluation. Risk factors, including Child-Pugh grading, tumour size, number, location, serum alpha-fetoprotein (AFP) level, track number, biopsy before RFA and electrode type were performed by univariate analysis. Further therapy and survival of seeding after RFA were assessed. Survival analysis was analysed by Kaplan-Meier method. RESULTS: Twelve patients (12 tumours) were diagnosed as seeding. It corresponds to an incidence of 1.6% (12/741) per patient and 0.9% (12/1341) per tumour. Seeding developed an average of 14.0 ± 8.1 months (6-33 months). Significant risk factors included tumour >3 cm (p = 0.031), subcapsular tumour (p = 0.031), biopsy before RFA (p = 0.001) and non-cool-tip electrode (p = 0.034). Eight patients received local therapy and four cases only received systematic therapy for uncontrolled advanced hepatic tumour or distal metastasis. Of eight patients receiving local therapy, one patient had local recurrence 16 months later and other seven patients did not have local recurrence for 3-73 months. The cumulative survival rates after seeding were 55.6%, 27.8%, 9.3% at 1, 3 and 5 years, respectively. CONCLUSION: Needle track seeding is a rare delayed complication after percutaneous RFA. Tumour >3 cm, subcapsular tumour, biopsy before RFA and non-cool-tip electrode are potential risk factors for seeding. Local therapies are effective methods for seeding patients.
