Seeding after radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis: A prospective study

Latteri, Federica; Sandonato, Luigi; Marco, Vito Di; Parisi, P.; Cabibbo, Giuseppe; Lombardo, Giovanna; Gallucci, M.; Midiri, Massimo; Latteri, M; Craxı̀, Antonio

doi:10.1016/j.dld.2007.12.021

Cited by 29 publications

(17 citation statements)

References 31 publications

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“…Several associated risk factors have been identified for neoplastic seeding following RFA for HCC, notably subcapsular tumor location [2,6] , poor tumor differentiation g rade [2] , multiple RFA sessions [6] , multiple electrode placements [6] and history of previous biopsy [6] . In an Italian study by Latteri et al [7] , the risk of neoplastic seeding after open RFA was virtually zero but the risk was as high as 1.4% after percutaneous RFA. Remarkably, most of these identified factors were based on seeding risk for HCC.…”

Section: Discussionmentioning

confidence: 99%

Needle track seeding: A real hazard after percutaneous radiofrequency ablation for colorectal liver metastasis

Liu¹,

Lee²,

Lai³

2009

WJG

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Neoplastic needle track seeding following percutaneous radiofrequency ablation (RFA) of secondary liver tumors is exceedingly rare. Reports on cutaneous tumor seeding after percutaneous RFA for colorectal liver metastasis are even rarer in the literature. Here we report a case of a 46-year-old female who developed an ulcerating skin lesion along the needle track of a previous percutaneous RFA site around 6 mo after the procedure. The previous RFA was performed by the LeVeen ® needle for a secondary liver tumor from a primary rectal cancer. The diagnosis of secondary skin metastasis was confirmed by fine needle aspiration cytology. The lesion was successfully treated with wide local excision. We believe that tumor seeding after percutaneous RFA in our patient was possibly related to its unfavorable subcapsular location and the use of an expansion-type needle. Hence, prophylactic ablation of the needle track should be performed whenever possible. Otherwise, alternative routes of tumor ablation such as laparoscopic or open RFA should be considered.

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Section: Discussionmentioning

confidence: 99%

Needle track seeding: A real hazard after percutaneous radiofrequency ablation for colorectal liver metastasis

Liu¹,

Lee²,

Lai³

2009

WJG

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“…The low risk of seeding after RFA (0%-1.4%) has been confirmed in other recent studies [30] . In a recent study from our group [31] , the risk of seeding of hepatocellular carcinoma after radiofrequency ablation was small (1.1% per patient, 95% CI, 0.19-5.84; 0.7% per procedure, 95% CI, 0.12-3.80).…”

Section: Needle Tract Seedingmentioning

confidence: 99%

Needle track seeding following percutaneous procedures for hepatocellular carcinoma

Cabibbo

Craxı̀²

2009

WJH

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Neoplastic seeding may arise after diagnostic or therapeutic percutaneous procedures for hepatocellular carcinoma. The true incidence of seeding with hepatocellular carcinoma is difficult to assess precisely, but a significant risk of seeding exists and is greater when performing diagnostic biopsy as compared to therapeutic percutaneous procedures [radiofrequency ablation, radiofrequency ablation (RFA); percutaneous ethanol injection, Percutaneous ethanol injection (PEI)]. Whenever liver transplantation is feasible, diagnostic needle biopsies should be avoided, but RFA and PEI are often needed as "bridge" treatments. The role of adjuvant treatments in reducing the incidence of seeding following RFA or PEI requires further evaluation.

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“…Besides resection, RFA is also an option for treating tumor seeding. Some authors suggest the open approach in subcapsular lesions to avoid this complication [35] .…”

Section: Tract Seedingmentioning

confidence: 99%

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

Fonseca

Santin

Gomes

et al. 2014

WJH

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Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient's co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician's experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes.

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Seeding after radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis: A prospective study

Cited by 29 publications

References 31 publications

Needle track seeding: A real hazard after percutaneous radiofrequency ablation for colorectal liver metastasis

Needle track seeding: A real hazard after percutaneous radiofrequency ablation for colorectal liver metastasis

Needle track seeding following percutaneous procedures for hepatocellular carcinoma

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

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