Risk factors for hemoglobinuria after ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous hemangiomas.

Fangyi Liu,Ping Liang,Zhigang Cheng,Zhiyu Han,Jianping Dou,Jie Yu,Xiaoling Yu

doi:10.18632/oncotarget.25379

Abstract

Thermal ablation of large hepatic cavernous hemangiomas may lead to intravascular hemolysis, hemoglobinuria, and even acute renal failure. This study aimed to identify the risk factors associated with hemoglobinuria after ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous hemangiomas. In our study, 11 related risk factors were analyzed using univariate and multivariate binary logistic regression model and Receiver operating characteristic curves to determine the contribution to hemoglobinuria after microwave ablation for 49 patients with 51 hepatic cavernous hemangiomas. By multivariate analysis, the ablation time (p = 0.021; Odds Ratio, 1.005), and the number of antenna insertions (p = 0.036; Odds Ratio, 3.568) were the independent risk factors associated with hemoglobinuria. The cutoff value for ablation time and the number of antenna insertions in predicting the presence of hemoglobinuria was 1185s (sensitivity, 75%; specificity, 69%) and 4.5 (sensitivity, 55%; specificity, 83%), respectively. Less than 5 of antenna insertions and less than 20 mins of ablation time may therefore be recommended in patients with microwave ablation of large hepatic cavernous hemangiomas, in order to reduce the occurrence of hemoglobinuria. This is the first report about the risk factors analysis associated with hemoglobinuria after thermal ablation for large hepatic cavernous hemangiomas.

Highlights

Hepatic cavernous hemangiomas (HCHs) are the most common benign neoplasms in liver, with the prevalence in the general population as many as 20% in autopsy studies [1]
This study aimed to identify the risk factors associated with hemoglobinuria after ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous hemangiomas
Less than 5 of antenna insertions and less than 20 mins of ablation time may be recommended in patients with microwave ablation of large hepatic cavernous hemangiomas, in order to reduce the occurrence of hemoglobinuria

Summary

Introduction

Hepatic cavernous hemangiomas (HCHs) are the most common benign neoplasms in liver, with the prevalence in the general population as many as 20% in autopsy studies [1]. The primary treatment is surgical resection, transarterial embolization, radiation therapy, and the use of a vascular endothelial growth factor (VEGF) inhibitor have been reported [5,6,7,8]. Thermal ablation, such as radiofrequency ablation (RFA) and microwave ablation (MWA), was safe, well-tolerated, and effective in markedly shrinking large HCHs and improving symptoms in most patients [9,10,11,12]. There has been no report about the risk factors analysis associated with hemoglobinuria after thermal ablation for large hepatic cavernous hemangiomas. This study aimed to identify the risk factors associated with hemoglobinuria after ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous hemangiomas

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Results

Conclusion