IDDF2022-ABS-0171 Frequency and risk factors for complications after ultrasound-guided percutaneous liver radiofrequency ablation in 363 sessions

Abstract

<h3>Background</h3> Radiofrequency ablation (RFA) has become a common treatment for patients with unresectable primary and secondary hepatic malignancies. Investigation of its complications has been limited. Major complications from percutaneous RFA are low (3.1%) in the study of Kong et al. involving 255 patients in 2009. We aimed to determine the frequency and factors that predict complications after RFA. <h3>Methods</h3> This was a retrospective study done over an 11-year period. 363 sessions of percutaneous radiofrequency ablation for the treatment of 812 liver tumors were included (297 sessions were done for the treatment of hepatocellular carcinoma and 66 for metastatic liver tumor). The authors divided the probable risk factors into four categories namely baseline demographics &amp; clinical features, biomedical profile, tumor characteristics and RFA-related factors. Sessions where &gt;1 tumor was within 5mm of a vital structure or &gt;3mm vessel were considered high-risk. Statistical Analysis was carried out using SPSS version 25. <h3>Results</h3> An average tumor number (2.14±1.56vs2.69±1.84, p=0.026) of primary and secondary hepatic malignancies with tumor size (3.64±1.78vs3.08±1.77, p=0.021) per session were included. There was 7.4% major (IDDF2022-ABS-0171 Figure 1. Pie charts showing a frequency of patients grouped according to the presence of major complication B frequency of major complication) and 4.4% minor complication rates (IDDF2022-ABS-0171 Figure 2. Pie charts showing a frequency of patients grouped according to the presence of minor complication B frequency of minor complication). The most common major complications are a liver abscess (1.9%) followed by organ damage (1.4%) and tumor bleeding (1.4%). 5 (0.01%) died in the immediate post-RFA period. 3 patients died due to RFA-related complications: intestinal perforation, hemothorax and tumor hemorrhage, while 2 died due to RFA-unrelated complications: massive upper GI bleeding and acute coronary syndrome. Preoperative antibiotic use (p=0.001), electrode type (p=0.01), largest tumor size (p=0.0001) and total RFA time (p=0.0001) were found to be associated with major complication (IDDF2022-ABS-0171 Table 1–3). On multivariate analysis, only the total RFA time was identified to be the significant risk factor for major (OR1.03;95%CI:1.016–1.048) complications (IDDF2022-ABS-0171 Table 4). <h3>Conclusions</h3> RFA of liver malignancies is a safe procedure with acceptable complication rates. However, prudence is needed in trying to decrease RFA time in a single session. Staged procedures may decrease complication rates.