Adverse effects of radiofrequency ablation of liver tumours in the Netherlands

Jansen, Matthijs; Duijnhoven, F.H. van; Hillegersberg, Richard van; Rijken, Arjen M.; Coevorden, Frits van; Sijp, Joost van der; Prevoo, Warner; Gulik, Thomas M. van

doi:10.1002/bjs.5059

Cited by 66 publications

(76 citation statements)

References 32 publications

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“…The overall mortality rate was 1.36% in our series, which was comparable to 0.2-2.1% in previous reports [29,[33][34][35][36]. The cause of death was hypovolaemic shock from tumour bleeding combined with hepatic decompensation, similar to the most common cause of death in other studies [29,[33][34][35][36].…”

Section: T C Macatula C-c Lin C-j Lin Et Alsupporting

confidence: 84%

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Radiofrequency ablation for hepatocellular carcinoma: use of lowvsmaximal radiofrequency power

Tc¹,

Cc²,

Lin³

et al. 2012

BJR

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Objectives: To investigate whether radiofrequency (RF) ablation with low power (LP) or maximal power (MP) for hepatocellular carcinoma (HCC) can achieve optimal ablation and fewer adverse effects. Methods: RF ablation was performed with MP in 101 patients (129 tumours) and with LP in 46 patients (61 tumours). MP RF ablation used power of .120 W. RF power below this was designated as LP. Clinical outcomes were also analysed in subgroups of highrisk tumours near the bile duct and blood vessels. Results: Primary effectiveness was achieved in 91.8% in the LP group and 89.9% in the MP group (p50.795). 1 and 2-year local tumour progression rates were 28% and 30%, respectively, in the LP group, and 24% and 29%, respectively, in the MP group (p50.70). 1 and 2-year survival rates were 98% and 98%, respectively, in the LP group, and 93% and 90%, respectively, in the MP group (p50.216). The MP group had more adverse effects, with post-RF ablation syndrome, asymptomatic pleural effusion and ascites, than the LP group (20% vs 39% in the MP group; p50.027); however, there was no significant difference in major complication rates (6% in the MP and LP groups; p50.497). Among the patients with high-risk tumours, RF ablation using MP vs LP was comparable in primary effectiveness (91.7% vs 95.2%; p50.618), local tumour progression (42.9% vs 29.2%; p50.304) and overall complications (5% vs 8%; p50.618). Conclusion: RF ablation with LP and MP are comparable in clinical outcomes but considerably fewer adverse effects were encountered in the LP group.

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Section: T C Macatula C-c Lin C-j Lin Et Alsupporting

confidence: 84%

“…The cause of death was hypovolaemic shock from tumour bleeding combined with hepatic decompensation, similar to the most common cause of death in other studies [29,[33][34][35][36].…”

Section: T C Macatula C-c Lin C-j Lin Et Alsupporting

confidence: 79%

Radiofrequency ablation for hepatocellular carcinoma: use of lowvsmaximal radiofrequency power

Tc¹,

Cc²,

Lin³

et al. 2012

BJR

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“…RFA is used in the treatment of unresectable LM to provide local control of the disease and palliation with the potential to improve survival [13,15,20,24,25]. Most investigators put a limit on tumor size (up to 4-5 cm) and number (<9) that can be ablated, but larger lesions and up to 15 lesions have been ablated [9,11,17].…”

Section: Discussion Radiofrequency Ablation (Rfa)mentioning

confidence: 99%

“…Proper positioning of the electrode is crucial to ensure complete destruction of the tumor and a 1 cm zone of normal liver parenchyma [11,12,20,21]. Ablation is monitored with an US by measuring the zone of increased echogenicity corresponding to coagulation of the tissue or by out gassing of dissolved nitrogen [13,14,19,20,22].…”

Section: Discussion Radiofrequency Ablation (Rfa)mentioning

confidence: 99%

Thermoablation of colorectal liver metastasis

Kulaylat

Gibbs

2010

Journal of Surgical Oncology

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Thermoablation is a local therapy that is effective in in situ destruction of colorectal liver metastasis while preserving surrounding normal liver tissue. It is less invasive compared to surgery, easy to use, and can be repeated. The therapy provides local control of unresectable disease and is an alternative therapy for small resectable lesions in patients with insufficient hepatic reserve after resection or coexistent comorbid conditions. It can artificially increase the resection margin thus increasing the number of patient candidate for resection. When used in conjunction with liver resection it clears the liver of multiple lesions that are surgically inaccessible or unresectable. Main limitations of the treatment are local recurrence of the disease, treatment-related complications, and questionable impact on patient. Outcome of therapy can be improved when used as part of multimodality treatment.

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“…[5][6][7][8] Hypertensive crisis related to unintended adrenal gland injury during RFA of liver tumor has also been reported. 9 We experienced a very rare case of hypertensive crisis after RFA for HCC without evidence of adrenal gland injury and dramatic surge in several adrenal hormones.…”

Section: Introductionmentioning

confidence: 99%

A Case of Hypertensive Crisis without a Surge in Adrenal Hormones after Radiofrequency Ablation as a Treatment for Primary Hepatocellular Carcinoma

Lee

Ryu

2017

Korean J Gastroenterol

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Radiofrequency ablation (RFA) is a minimally invasive procedure that has been considered as a relatively safe treatment for patients with small hepatocellular carcinoma (HCC). However, RFA has been shown to be associated with complications including mechanical and thermal damage. A 74-year-old man with hepatitis C virus-associated HCC was admitted to our hospital. Abdominal computed tomography revealed two lobulated-HCC in segments 4 and 5. He had no medical history of hypertension and cardiac disease. During RFA, blood pressure was elevated to 200/140 mmHg. There was no evidence of pulmonary embolism, aortic dissection, or ischemic heart disease. Laboratory findings for catecholamine surge were all within normal limits. After continuous intravenous nitroglycerin and oral beta-blocker treatment, patient's blood pressure gradually decreased and back within the normal range. Hypertensive crisis after RFA treatment for HCC is rare. Most reported cases of hypertensive crisis during RFA were related to adrenal gland injury with a release of catecholamine. In our case, the site of HCC was not close to the adrenal gland, and there was no evidence of catecholamine surge. Herein, we report a very rare case of hypertensive crisis without a surge in adrenal hormones after RFA treatment for HCC. (Korean J Gastroenterol 2017;70:198-201)

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Adverse effects of radiofrequency ablation of liver tumours in the Netherlands

Cited by 66 publications

References 32 publications

Radiofrequency ablation for hepatocellular carcinoma: use of lowvsmaximal radiofrequency power

Radiofrequency ablation for hepatocellular carcinoma: use of lowvsmaximal radiofrequency power

Thermoablation of colorectal liver metastasis

A Case of Hypertensive Crisis without a Surge in Adrenal Hormones after Radiofrequency Ablation as a Treatment for Primary Hepatocellular Carcinoma

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