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Radiofrequency ablation of hepatocellular carcinoma in patients with decompensated cirrhosis: evaluation of therapeutic efficacy and safety

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Authors
Kim, Young Kon; Kim, Chong Soo; Chung, Gyong Ho; Han, Young Min; Lee, Sang Yong; Jin, Gong Yong; Lee, Jeong Min
Issue Date
2006-04-25
Publisher
American Roentgen Ray Society
Citation
AJR Am J Roentgenol. 2006 ;186(5 Suppl):S261-268.
Keywords
cirrhosisdecompensationhepatocellular carcinomaliveradiofrequency ablationCarcinoma, Hepatocellular/*complications/*surgery*Catheter Ablation/adverse effectsLiver Neoplasms/*complications/*surgery
Abstract
OBJECTIVE: Our objective was to determine the therapeutic efficacy and safety of radiofrequency ablation in the treatment of hepatocellular carcinoma (HCC) in patients with decompensated cirrhosis. SUBJECTS AND METHODS: Nineteen patients with 26 HCC nodules (range, 0.8-5 cm; mean, 1.96 cm) and decompensated liver cirrhosis (mean Child score, 10.7) were treated with radiofrequency ablation using cooled-tip electrodes and a 200-W generator. Radiofrequency ablation was performed under the guidance of sonography or CT. Procedure-related complications, therapeutic efficacy, each patient's survival, changes in blood test results--that is, serum aminotransferase and bilirubin--and changes in the Child score before and after ablation therapy were analyzed. To assess the therapeutic response of the tumor to radiofrequency ablation, we performed contrast-enhanced CT after the procedure and during follow-up. RESULTS: Complete necrosis without marginal recurrence at the 6-month follow-up was attained in 23 lesions (88.5%). During follow-up (mean, 13.3 months), one patient experienced a remote tumor recurrence in the liver. The median survival time was 12.0 +/- 1.7 months. Two patients died of liver failure--one at 2 months and one at 4 months after treatment. The other patients were followed for at least 6 months (range, 6-28 months; mean, 12 months). The first and second weeks after therapy, the serum aminotransferase and bilirubin levels were significantly higher than were pretreatment levels (p < 0.05). However, 3 weeks after therapy, those figures were nearly restored to the pretreatment levels. The mean Child scores 3 weeks after radiofrequency ablation (10.8) were similar to those before treatment (10.7). CONCLUSION: Radiofrequency ablation can be used selectively for treatment of HCC in patients with decompensated cirrhosis but has the potential to aggravate the preexisting hepatic dysfunction.
ISSN
0361-803X (Print)
1546-3141 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16632686

http://hdl.handle.net/10371/15701
DOI
https://doi.org/10.2214/AJR.04.1266
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College of Medicine/School of Medicine (의과대학/대학원)Radiology (영상의학전공)Journal Papers (저널논문_영상의학전공)
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