Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients.
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.
Curley
Steven A
SA
Department of Surgical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030-4095, USA. scurley@mdanderson.org
Marra
Paolo
P
Beaty
Karen
K
Ellis
Lee M
LM
Vauthey
J Nicolas
JN
Abdalla
Eddie K
EK
Scaife
Courtney
C
Raut
Chan
C
Wolff
Robert
R
Choi
Haesun
H
Loyer
Evelyne
E
Vallone
Paolo
P
Fiore
Francesco
F
Scordino
Fabrizio
F
De Rosa
Vincenzo
V
Orlando
Raffaele
R
Pignata
Sandro
S
Daniele
Bruno
B
Izzo
Francesco
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D013781:Texas / Q000453:epidemiology; D013997:Time Factors