title: Percutaneous treatment of hepatocellular carcinoma in patients with cirrhosis: a comparison of the safety of cryoablation and radiofrequency ablation.
abstract: OBJECTIVE
  To compare the safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis.
  
  
  METHODS
  This retrospective HIPAA-compliant study received institutional review board approval. Forty-two adult patients with cirrhosis underwent image-guided percutaneous ablation of hepatocellular carcinoma from 2003 to 2011. Twenty-five patients underwent 33 cryoablation procedures to treat 39 tumors, and 22 underwent 30 radiofrequency ablation procedures to treat 39 tumors. Five patients underwent both cryoablation and radiofrequency ablation procedures. Complication rates and severity per procedure were compared between the ablation groups. Potential confounding patient, procedure, and tumor-related variables were also compared. Statistical analyses included Kruskal-Wallis, Wilcoxon rank sum, and Fisher's exact tests. Two-sided P-values <0.05 were considered significant.
  
  
  RESULTS
  The overall complication rates, 13 (39.4%) of 33 cryoablation procedures versus eight (26.7%) of 30 radiofrequency ablation procedures and severe/fatal complication rates, two (6.1%) of 33 cryoablation procedures versus one (3.3%) of 30 radiofrequency ablation procedures, were not significantly different between the ablation groups (both P=0.26). Severe complications included pneumothoraces requiring chest tube insertion during two cryoablation procedures. One death occurred within 90 days of a radiofrequency ablation procedure; all other complications were managed successfully.
  
  
  CONCLUSIONS
  No significant difference was seen in the overall safety of image-guided percutaneous cryoablation and radiofrequency ablation in the treatment of hepatocellular carcinoma in patients with cirrhosis.
authors: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States. Electronic address: rmdunne@partners.org.
authors: Ruth M
authors: RM
authors: Dunne
authors: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States. Electronic address: pshyn@partners.org.
authors: Paul B
authors: PB
authors: Shyn
authors: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States. Electronic address: jcsung@gmail.com.
authors: Jeffrey C
authors: JC
authors: Sung
authors: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States. Electronic address: statli@partners.org.
authors: Servet
authors: S
authors: Tatli
authors: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States.
authors: Paul R
authors: PR
authors: Morrison
authors: Department of Biostatistics and Computational Biology, Dana Farber Cancer Institute, 450 Brookline Avenue, CLSB 11007, Boston, MA 02215, United States; Department of Biostatistics, Harvard School of Public Health, Boston, MA 02215, United States. Electronic address: pcata@jimmy.harvard.edu.
authors: Paul J
authors: PJ
authors: Catalano
authors: Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, United States. Electronic address: sgsilverman@partners.org.
authors: Stuart G
authors: SG
authors: Silverman
mesh_terms: D000368:Aged; D001652:Bile Ducts / Q000293:injuries / Q000473:pathology / Q000528:radiation effects; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003452:Cryosurgery / Q000009:adverse effects*; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009212:Myoglobinuria / Q000175:diagnosis / Q000209:etiology*; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology*; D016896:Treatment Outcome
keywords: Ablation techniques; Carcinoma, Hepatocellular; Liver cirrhosis