High Fever After Radiofrequency Ablation of Hepatocellular Carcinoma

Yoshikawa, Takaaki; Ohana, Masaya; Fukuda, Akira

doi:10.1053/j.gastro.2017.12.037

Cited by 6 publications

(7 citation statements)

References 3 publications

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“…Focusing on the fever after HCC ablation therapy is not only related to the quality of life of patients post-procedurally or to the occurrence of complications [ 8 ], but also some recent reports link prolonged post-intervention fever with higher tumor recurrence rates at one year [ 9 ]. Furthermore, one recent report found that postoperative infection and its associated manifestations among patients receiving ultrasound-guided thermal ablation for HCC adversely affected tumor progression [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

Abdelkader¹,

Elkhalek²,

Hosny³

et al. 2023

ceh

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Aim of the study Hepatocellular carcinoma (HCC) is a leading cause of mortality among patients with liver cirrhosis. According to the current practice guidelines, different ablations are used either as curative or palliative therapies. The current study aimed at determining bacterial infections as causes of fever and the predictive role of procalcitonin (PCT) among patients with HCC who had ablation therapy. Material and methods This cross sectional study was carried out on 100 patients with HCC during the period from November 2019 to December 2021. All patients were evaluated by full history taking, clinical examination, complete blood picture (CBC), liver biochemistry, coagulation profile, kidney function, C-reactive protein (CRP), serum PCT and blood cultures. All were done for all participants at the 4 th day follow-up after the procedures of ablation. HCC was treated according to the guidelines. Results The frequency of fever after HCC ablation was 64% with variable intensities. Bacterial cultures were positive in 20 patients (20%). Twenty-four out of 100 patients had abnormally high PCT level. There was a highly statistically significant increase of PCT level in patients with a high CRP count and positive blood culture, p < 0.05. There was a statistically significant correlation between increased levels of PCT and levels of CRP, WBCs, albumin, AST, ALT, degree of fever, creatinine and BUN. Conclusions Bacterial infection accounts for 20% of fever among HCC patients after ablation therapy. PCT is 100% sensitive and specific for detection of the bacterial causes of fever among those patients.

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Section: Discussionmentioning

confidence: 99%

Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

Abdelkader¹,

Elkhalek²,

Hosny³

et al. 2023

ceh

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“…C. perfringens infection most commonly causes food-poisoning and anaerobic cellulitis, and it might also cause severe infection with gas gangrene, septic shock, myositis, and hemolysis [ 18 ]. Few studies have discussed the emergence of C. perfringens −induced liver abscess associated with post-RFA and microwave ablation treatment [ 5 , 6 , 7 , 8 ], as it has been a rare organism of liver abscess originating from local ablation treatment. Two papers have mentioned malignancies originating from gastric and colonic regions with metastasis to liver [ 5 , 8 ], with one of the articles reporting microwave ablation of the liver metastasis had been performed [ 8 ], while one of the patients developed C. perfringens −related liver abscess and expired from cardiopulmonary failure 16 days after the procedure [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Usual clinical presentations of the complication include fever, chills, right upper quadrant abdominal pain, and general malaise [ 4 ]. This case report is focused at intra-tumoral liver abscess formation after RFA due to severe Clostridium perfringens infection, which has rarely been documented previously [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Hepatic Clostridium Perfringens Abscess Formation after Radiofrequency Ablation Therapy for Hepatocellular Carcinoma: Report of a Rare Case

et al. 2021

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Liver abscess formation is one of the major complications following radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). Clostridium perfringens is a rare but fatal (mortality rate: 70–100%) organism that could lead to severe sepsis. We presented a case where a 63-year-old woman with diabetes mellitus, hypertension, chronic hepatitis B-related cirrhosis in Child-Pugh class A and HCC with initial TNM stage II who had undergone 2 sessions of transarterial chemoembolization. RFA was performed for 4 small HCC due to poor effect of previous transarterial chemoembolization. However, all 4 treated tumors developed liver abscesses presenting with septic shock within 1 day. Aspirated abscesses and blood culture both yielded C. perfringens infection. After intensive care, optimal intravenous antibiotic, and abscesses aspiration, the patient recovered successfully. All tumors achieved complete response during the follow-up period without local recurrence. The clinical presentations and risk factors of C. perfringens-related liver abscess after RFA will be discussed in this manuscript.

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“…[ 21 ] Malignant tumor-related PLA have been reported to be mainly caused by TACE and RFA treatment of hepatocellular carcinoma. [ 3 – 7 , 23 ] Previous studies have shown that potential malignant tumor-related PLA had common clinical features with nonpotential malignant tumor-related PLA. Our study showed that the overall incidence of malignant tumor-related PLA was 9.88%, and that of potential malignancies rate of PLA was 4.65%, which was higher than the overall incidence that was reported in previous reports (2.15%–3.5%).…”

Section: Discussionmentioning

confidence: 99%

“…Since PLA can be resulted from interventional treatments of liver cancer such as transarterial chemoembolization (TACE), [ 3 – 5 ] and thermal ablation (radiofrequency ablation, microwave ablation). [ 6 , 7 ] Additionally, studies have shown that PLA can be served as a warning sign of liver cancer, [ 8 – 10 ] cholangiocarcinoma, [ 10 – 12 ] gastrointestinal carcinoma, [ 11 , 13 – 17 ] lung cancer, [ 11 ] or early adenosquamous carcinoma. [ 18 ] Early diagnosis and treatment are the key for PLA with potential malignant tumors.…”

Section: Introductionmentioning

confidence: 99%

The aura of malignant tumor

Wu²,

Qin³

et al. 2020

Medicine

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The global incidence of pyogenic liver abscess (PLA) is increasing, but related reports of malignant tumor-related PLA are infrequent. Potential malignant tumors of PLA have been reported, but there is no relevant predictive model for this subsection of patients. To explore the risk factors of malignant tumor-related PLA. A retrospective analysis about a total of 881 patients who had been diagnosed with PLA from January 2005 to May 2018 was performed. The incidence of malignant tumor-related PLA in the study was 9.99% (88/881) out of all PLA cases. And that of potential malignant tumors with PLA was 4.65% (41/881). There were 62 patients with malignant tumor-related PLA in the observation group, while 146 cases without malignant tumor-related PLA were considered as control group. The data from 52 cases of malignant tumor and nonmalignant tumor-related PLA was verified. The malignant tumor type was mainly hepatobiliary malignant tumor, which occupies 72.3% (45/62) in all malignant tumor related PLA cases used to the model. Compared with nonmalignant tumor group, the rate of ineffective and mortality was higher in the malignant tumor group [19.4%(12/62) vs 7.5%(11/148), P = .01]. Multivariate analysis suggested that hepatobiliary interventional therapy or surgery, hepatitis B virus infection, multiple abscesses, portal embolism, and bile duct dilatation were independent risk factors for potential malignant tumors within the patients who combined with PLA. PLA could be considered as an early warning sign of potential malignant tumors. Malignant tumor-related PLA had a poor prognosis. Patients with PLA who have more than one independent risk factor or logit( P ) > −1.694 may be considered as the high risk group for potential hepatobiliary or colorectal malignant tumors.

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High Fever After Radiofrequency Ablation of Hepatocellular Carcinoma

Cited by 6 publications

References 3 publications

Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

Bacterial infections and fever after hepatocellular carcinoma ablation therapy: predictive role of procalcitonin

Hepatic <b><i>Clostridium Perfringens</i></b> Abscess Formation after Radiofrequency Ablation Therapy for Hepatocellular Carcinoma: Report of a Rare Case

The aura of malignant tumor

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