Complications after Radiofrequency Ablation of 233 Hepatic Tumors

Abstract

Objective: The only curative treatment for primary and secondary hepatic malignancies is surgery and liver transplantation. Thus, the majority of the patients are not candidates for resection, and there is a lack of organs. For these reasons, alternative treatment modalities such as radiofrequency ablation (RFA) are employed. The objective of this paper is to evaluate the incidence and types of complications related to open and percutaneous RFA. Method: This is a retrospective study of patients with hepatic malignancies treated by RFA. Tumor size, location, numbers of nodules, approach, histology and associated procedures were analyzed and correlated to complications. Results: A total of 151 patients with primary and secondary hepatic malignancies were included: 58 with hepatocellular carcinoma (HCC), 68 with metastases from colorectal cancer and 25 with other types of tumors. Complications occurred in 24.5% of the patients, mostly (58.9%) in those with HCC. Ascites was the most common complication, followed by wound infection. The only two significant factors associated with complications were the presence of HCC (p = 0.0087) and two or more lesions (p = 0.0323). The mortality rate was 0.69%. Conclusion: RFA is a safe technique, but complications may occur and are multifactorial. Appropriate patient selection, early complication recognition and adequate treatment are essential.