title: Consequences of needle tract seeding of hepatocellular cancer after liver transplant.
abstract: Although liver biopsy is a relatively safe procedure, needle tract seeding (NTS) of hepatocellular carcinoma (HCC) is described in up to 5% of patients after liver biopsy. The rate of NTS in patients with HCC who had liver transplantation is unknown. We performed a retrospective analysis of 759 HCC cases from August 1992 to August 2011. Demographics, ethnicities, risk factors, tumor characteristics, treatments, recurrence, and survival were collected. Patients who underwent percutaneous liver biopsy, resection, and transplant were identified. In all, 359 underwent biopsy to diagnose HCC and 42 patients underwent liver transplant. None of 171 patients who underwent radiofrequency ablation alone had seeding. None of the 11 patients who had biopsy and radiofrequency ablation performed in a single session developed NTS; however, two of 12 patients who had biopsy and radiofrequency ablation performed at separate sessions had NTS. Two patients underwent liver transplantation and subsequently developed needle tract seeding eventually died from HCC. Although the incidence of needle tract seeding was low in liver transplant patients, it can potentially change a curative therapy into a non-curative one. Single-session liver biopsy and radiofrequency ablation may reduce the risk of needle tract seeding of HCC.
authors.affiliation: Department of Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, USA.
authors.forename: Kristi T
authors.initials: KT
authors.lastname: Lopez
authors.forename: Scott K
authors.initials: SK
authors.lastname: Kuwada
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wong
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009339:Needles; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D009366:Neoplasm Seeding; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: liver transplant; needle tract seeding; radiofrequency ablation