Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients
Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients
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DOI：
10.1097/01.sla.0000118373.31781.f2
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发表时间：
2004-04-01
影响因子：
9
通讯作者：
Izzo, F
中科院分区：
文献类型：
--
作者：
Curley, SA;Marra, P;Izzo, F
背景：射频消融术(RFA)已成为不能切除的原发性和继发性肝脏恶性肿瘤患者的常用治疗方法。我们进行了前瞻性分析，以确定与肝脏肿瘤射频消融相关的早期(30天内)和晚期(30天以上)并发症的发生率。方法：将1996年1月1日至2002年6月30日期间接受射频消融治疗的所有肝脏恶性肿瘤患者输入前瞻性数据库。结果：共608例患者接受RFA治疗，其中男性345例(56.7%)，女性263例(43.3%)，年龄中位数58岁(18-85岁)。术中开放RFA 382例(62.8%)，经皮RFA 226例(37.2%)。与治疗相关的死亡率为0.5%。早期并发症43例(7.1%)。早期并发症发生在开放式RFA组(382例患者中33例[8.6%])、经皮RFA组(10例[4.4%]226例，P<；0.01)、肝硬化组(194例患者25例[12.9%])和非肝硬化组(414例患者31例[7.5%]并发症，P<；0.05)。15名患者(2.4%)出现了晚期并发症，开放和经皮RFA治疗的发生率没有差异。总的近期和远期并发症发生率为9.5%。结论：肝肿瘤射频消融术具有较低的死亡率和并发症发生率。虽然相对罕见，但晚期并发症可能会发生，进行肝脏RFA的医生必须意识到这些延迟治疗相关的问题。
Background: Radiofrequency ablation (RFA) has become a common treatment of patients with unresectable primary and secondary hepatic malignancies. We performed this prospective analysis to determine early (within 30 days) and late (more than 30 days after) complication rates associated with hepatic tumor RFA.Methods: All patients treated between January 1, 1996 and June 30, 2002 with RFA for hepatic malignancies were entered into a prospective database. Patients were evaluated during RFA treatment, throughout the immediate post RFA course, and then every 3 months after RFA to assess for the development of treatment-related complications.Results: A total of 608 patients, 345 men (56.7%) and 263 women (43.3%), with a median age of 58 years (range 18-85 years) underwent RFA of 1225 malignant liver tumors. Open intraoperative RFA was performed in 382 patients (62.8%), while percutaneous RFA was performed in 226 (37.2%). The treatment-related mortality rate was 0.5%. Early complications developed in 43 patients (7.1%). Early complications were more likely to occur in patients treated with open RFA (33 [8.6%] of 382 patients) compared with percutaneous RFA (10 [4.4%] 226 patients, P < 0.01), and in patients with cirrhosis (25 [12.9%] complications in 194 patients) compared with noncirrhotic patients (31 [7.5%] complications in 414 patients, P < 0.05). Late complications arose in 15 patients (2.4%) with no difference in incidence between open and percutaneous RFA treatment. The combined overall early and late complication rate was 9.5%.Conclusions: Hepatic tumor RFA can be performed with low mortality and morbidity rates. Though relatively rare, late complications can develop and physicians performing hepatic RFA must be cognizant of these delayed treatment-related problems.