Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients

被引:294
作者
Curley, SA
Marra, P
Beaty, K
Ellis, LM
Vauthey, JN
Abdalla, EK
Scaife, C
Raut, C
Wolff, R
Choi, H
Loyer, E
Vallone, P
Fiore, F
Scordino, F
De Rosa, V
Orlando, R
Pignata, S
Daniele, B
Izzo, F
机构
[1] Univ Texas, MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX 77030 USA
[2] Univ Texas, MD Anderson Canc Ctr, Dept Med Oncol, Houston, TX 77030 USA
[3] Univ Texas, MD Anderson Canc Ctr, Dept Hepatol, Houston, TX 77030 USA
[4] Univ Texas, MD Anderson Canc Ctr, Dept Diagnost Imaging, Houston, TX 77030 USA
[5] G Pascale Natl Canc Inst, Naples, Italy
[6] Univ Naples Federico II, Dept Infect Dis, Naples, Italy
关键词
D O I
10.1097/01.sla.0000118373.31781.f2
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Radiofrequency ablation (RFA) has become a common treatment of patients with unresectable primary and secondary hepatic malignancies. We performed this prospective analysis to determine early (within 30 days) and late (more than 30 days after) complication rates associated with hepatic tumor RFA. Methods: All patients treated between January 1, 1996 and June 30, 2002 with RFA for hepatic malignancies were entered into a prospective database. Patients were evaluated during RFA treatment, throughout the immediate post RFA course, and then every 3 months after RFA to assess for the development of treatment-related complications. Results: A total of 608 patients, 345 men (56.7%) and 263 women (43.3%), with a median age of 58 years (range 18-85 years) underwent RFA of 1225 malignant liver tumors. Open intraoperative RFA was performed in 382 patients (62.8%), while percutaneous RFA was performed in 226 (37.2%). The treatment-related mortality rate was 0.5%. Early complications developed in 43 patients (7.1%). Early complications were more likely to occur in patients treated with open RFA (33 [8.6%] of 382 patients) compared with percutaneous RFA (10 [4.4%] 226 patients, P < 0.01), and in patients with cirrhosis (25 [12.9%] complications in 194 patients) compared with noncirrhotic patients (31 [7.5%] complications in 414 patients, P < 0.05). Late complications arose in 15 patients (2.4%) with no difference in incidence between open and percutaneous RFA treatment. The combined overall early and late complication rate was 9.5%. Conclusions: Hepatic tumor RFA can be performed with low mortality and morbidity rates. Though relatively rare, late complications can develop and physicians performing hepatic RFA must be cognizant of these delayed treatment-related problems.
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页码:450 / 458
页数:9
相关论文
共 38 条
[1]  
BARNETT CC, 2002, OP TECH GEN SURG, V4, P65
[2]   Underlying liver disease, not tumor factors, predicts long-term survival alter resection of hepatocellular carcinoma [J].
Bilimoria, MM ;
Lauwers, GY ;
Doherty, DA ;
Nagorncy, DM ;
Belghiti, J ;
Do, KA ;
Regimbeau, JM ;
Ellis, LM ;
Curley, SA ;
Ikai, I ;
Yamaoka, Y ;
Vauthey, JN .
ARCHIVES OF SURGERY, 2001, 136 (05) :528-534
[3]   Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy [J].
Bismuth, H ;
Adam, R ;
Levi, F ;
Farabos, C ;
Waechter, F ;
Castaing, D ;
Majno, P ;
Engerran, L .
ANNALS OF SURGERY, 1996, 224 (04) :509-520
[4]   Safety and efficacy of radiofrequency thermal ablation in advanced liver tumors [J].
Bowles, BJ ;
Machi, J ;
Limm, WML ;
Severino, R ;
Oishi, AJ ;
Furumoto, NL ;
Wong, LL ;
Oishi, RH .
ARCHIVES OF SURGERY, 2001, 136 (08) :864-868
[5]   Percutaneous radiofrequency ablation of small hepatocellular carcinoma: long-term results [J].
Buscarini, L ;
Buscarini, E ;
Di Stasi, M ;
Vallisa, D ;
Quaretti, P ;
Rocca, A .
EUROPEAN RADIOLOGY, 2001, 11 (06) :914-921
[6]  
Buscarini L, 2001, HEPATO-GASTROENTEROL, V48, P15
[7]   Radio-frequency ablation of liver tumors: Assessment of therapeutic response and complications [J].
Choi, H ;
Loyer, EM ;
DuBrow, RA ;
Kaur, H ;
David, CL ;
Huang, S ;
Curley, S ;
Charnsangavej, C .
RADIOGRAPHICS, 2001, 21 :S41-S54
[8]  
Choy Pui Yee Grace, 2002, N Z Med J, V115, pU128
[9]  
Chung MH, 2001, SURG ENDOSC-ULTRAS, V15, P1020
[10]   Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies - Results in 123 patients [J].
Curley, SA ;
Izzo, F ;
Delrio, P ;
Ellis, LM ;
Granchi, J ;
Vallone, P ;
Fiore, F ;
Pignata, S ;
Daniele, B ;
Cremona, F .
ANNALS OF SURGERY, 1999, 230 (01) :1-8