title: Percutaneous radiofrequency ablation of hepatocellular carcinoma in 14 patients undergoing regular hemodialysis for end-stage renal disease.
abstract: OBJECTIVE
  Management of hepatocellular carcinoma is a major problem in the care of patients undergoing regular hemodialysis treatments, mainly because of a high prevalence of hepatitis C virus infection. The purpose of this study was retrospective assessment of the safety and efficacy of percutaneous radiofrequency ablation of hepatocellular carcinoma in the care of patients with end-stage renal disease undergoing regular hemodialysis treatments.
  
  
  METHODS
  Between October 2004 and June 2008, 14 carefully selected hemodialysis patients with hepatocellular carcinoma (five naïve, nine recurrent) underwent a total of 19 radiofrequency ablation treatments. An internally cooled or expandable electrode was used. After tumor ablation, the insertion site at the liver surface was subjected to additional ablation to reduce the bleeding risk.
  
  
  RESULTS
  The Child-Pugh score was 6 or better in all patients but one. The number of tumors was one or two, and the tumor diameter was 35 mm or less in all treatments. No complication such as intraperitoneal hemorrhage was found in any treatment. Local tumor progression was found after one treatment and was successfully managed with subsequent radiofrequency ablation. During the mean observation period of 343 days, there was only one death, of heart failure, among the five patients with naïve tumors.
  
  
  CONCLUSIONS
  The safety and effectiveness of radiofrequency ablation were not compromised in this series of selected patients with hepatocellular carcinoma who were undergoing hemodialysis. Radiofrequency ablation is a promising option for small hepatocellular carcinomas in patients undergoing regular hemodialysis treatments.
authors.affiliation: Department of Gastroenterology, Mitsui Memorial Hospital, 1 Kanda-izumi cho, Chiyoda-Ku, Tokyo, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kondo
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tomizawa
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tateishi
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Kazumi
authors.initials: K
authors.lastname: Tagawa
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000451:nursing*; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D016896:Treatment Outcome