title: Radiofrequency ablation for the treatment of hepatocellular carcinoma with decompensated cirrhosis.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is used to treat early-stage hepatocellular carcinoma (HCC), but is sometimes avoided in patients with decompensated liver cirrhosis because of the possible side effect of deterioration of liver function.
  
  
  OBJECTIVE
  In this study, we report the safety and effects of RFA for treating HCC patients with Child-Pugh B/C liver cirrhosis.
  
  
  METHODS
  Sixty-six consecutive HCC patients with Child-Pugh B/C cirrhosis, who were treated by RFA, were enrolled in this study. We analyzed patient outcomes, the complications of RFA, and changes in liver function and tumor markers.
  
  
  RESULTS
  Fifty-six patients were classified as Child-Pugh class B, and 10 were classified as class C. The overall survival rates in patients with Child-Pugh B and C cirrhosis were 82 and 83% at 1 year and 47 and 31% at 3 years, respectively. Serum total bilirubin (T.Bil), albumin, prothrombin time, ascites, and encephalopathy were unchanged at 1, 3, and 6 months after RFA in patients with Child-Pugh B cirrhosis; however, serum T.Bil levels increased significantly at 6 months after RFA in 6/10 (60%) patients with Child-Pugh C cirrhosis. Hemothorax and rupture of esophageal varices were observed in 2 patients; however, there were no complications related to poor liver function.
  
  
  CONCLUSIONS
  RFA is a useful modality for treating HCC in patients with poor liver function such as Child-Pugh B and C, but careful monitoring after RFA must be needed.
authors.affiliation: Department of Liver Disease, Okayama City Hospital, Kita-ku, Okayama, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Wakuta
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nouso
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kariyama
authors.forename: Mamoru
authors.initials: M
authors.lastname: Nishimura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kishida
authors.forename: Nozomu
authors.initials: N
authors.lastname: Wada
authors.forename: Takaaki
authors.initials: T
authors.lastname: Mizushima
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Higashi
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome