Assessment of viable tumour tissue attached to needle applicators after local ablation of liver tumours.
OBJECTIVE
Local recurrence and needle track seeding are serious complications after local ablation for liver malignancies and potentially affect long-term survival. The aim of this study was to assess the incidence of viable tissue adherent to the needle applicators after ablation to gain insight into the possible mechanisms of local recurrence and needle track seeding.


METHODS
A total of 40 consecutive patients underwent 59 local liver ablations. Cells and tissue attached to the needle applicators were analysed for morphology (HE, PAP and Giemsa staining) and viability (G6PD staining).


RESULTS
Macroscopic tissue adherence was visible following 31 of the ablative procedures, all with radiofrequency ablation. Four applications were performed percutaneously and 27 during an open procedure. Morphologically intact tumour cells could be identified in 8 patients (20%), and viable tumour cells in 5 patients (12.5%). Morphologically intact tumour cells or viable tumour cells could only be demonstrated when track ablation was not performed.


CONCLUSIONS
Viable tumour cells adherent to the needle applicators were found in an alarming 12.5% of patients after local ablation. We recommend track ablation not only after the procedure but also during any shifting and (re-)positioning to prevent shedding of viable tumour cells during or after ablation.
Snoeren
Nikol
N
Department of Surgery, Academic Medical Centre, Meibergdreef 9, Amsterdam, The Netherlands.
Jansen
Maarten C
MC
Rijken
Arjen M
AM
van Hillegersberg
Richard
R
Slooter
Gerrit
G
Klaase
Joost
J
van den Tol
Petrousjka M
PM
van der Linden
Edwin
E
Ten Kate
Fibo J W
FJ
van Gulik
Thomas M
TM
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D009339:Needles / Q000009:adverse effects; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000473:pathology*; D009366:Neoplasm Seeding