Percutaneous radio-frequency liver tumor ablation: what are the risks? Livraghi T, Solbiati L, Meloni MF, et al., Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 2003;226:441–51

Abstract

The purpose of this investigation is to report complications encountered by members of a large collaborative group who performed radio-frequency (RF) ablation in patients with focal liver cancer. Members of 41 Italian centers used a percutaneous, internally cooled RF ablation technique and a standardized protocol for follow-up of treated patients. A questionnaire was used to determine complications and mortality, and their relationship to the RF procedure. Enrollment included 2320 patients with 3554 liver lesions (mean size, 3.1 cm); of these patients 1610 had hepatocellular carcinoma, 693 had metastases, and 17 had cholangiocarcinoma. All 3554 hepatic tumors were treated. Six deaths (0.3%) were noted. These included two deaths caused by multiorgan failure after intestinal perforation; one case each of septic shock after peritonitis caused by Staphylococcus aureus, massive hemorrhage after tumor rupture, liver failure after stenosis of the right bile duct; and one case of sudden death of unknown cause 3 days after the procedure. A total of 50 patients (2.2%) had additional major complications; the most frequent of these were peritoneal hemorrhage, neoplastic seeding, intrahepatic abscesses, and intestinal perforation. An increased number of RF sessions were related to a higher rate of major complications (p < 0.01), whereas the number of complications was not significantly different when tumor size or electrode type were compared. Minor complications were observed in <5% of patients. The authors conclude that RF ablation is a relatively low risk procedure for the treatment of focal liver tumors.