[Clinical features of liver abscess developed after radiofrequency ablation and transarterial chemoembolization for hepatocellular carcinoma].
OBJECTIVE
Radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) have been applied for treating hepatocellular carcinoma (HCC), but procedure-related complications can be a serious problem. This study was conducted to evaluate the clinical features of HCC patients who developed liver abscess after RFA and TACE, as compared to those patients without malignancy.


METHODS
In our center, from December 1999 to March 2004, 31 cases of liver abscess developed after local treatment of HCC (13/751 after RFA and 18/8417 after TAE), which correspond to 5.1% of the total cases (602) of liver abscess. We evaluated the patients' clinical features, the abscess characteristics, the bacteriology, treatment modality, hospital days and mortality, as compared to those characteristics of 263 abscess patients without malignancy.


RESULTS
The time required to diagnose liver abscess was longer in the TACE group (24.8+/-16.5 days) compared to that of the other two groups (12.2+/-9.0 days in the RFA group, 9.6+/-7.5 days in the controls, P=0.001). Gas-forming liver abscess is most frequently found in the RFA groups (76.9%). There were more hospitalized days for the TACE groups than for the RFA group and the controls (34.7+/-19.8 vs. 15.2+/-9.2 vs. 18.6+/-10.9 days, respectively, P<0.001). Two patients (11%) in the TACE group died of sepsis and liver failure.


CONCLUSIONS
For the patients with prolonged fever after RFA and especially after TACE for HCC, a diagnosis of liver abscess should be suspected earlier to reduce the morbidity and mortality due to liver abscess per se and also the sepsis-related decompensation of the liver.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
Min Hyung
MH
Kim
Moon Seok
MS
Choi
Yong Sung
YS
Choi
Do Young
DY
Kim
Ji Min
JM
Lee
Seung Woon
SW
Paik
Joon Hyuek
JH
Lee
Kwang Cheol
KC
Koh
Byung Cheol
BC
Yoo
Dongil
D
Choi
Jong Chul
JC
Rhee
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000628:therapy*; D017115:Catheter Ablation / Q000009:adverse effects*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged