Masaki Maeda1, Issei Saeki1, Isao Sakaida1, Hiroshi Aikata2, Yasuyuki Araki3, Chikara Ogawa4, Kazuya Kariyama5, Kazuhiro Nouso5, Mikiya Kitamoto6, Haruhiko Kobashi7, Shuichi Sato8, Hiroshi Shibata9, Kouji Joko10, Shintaro Takaki11, Hiroyuki Takabatake12, Akemi Tsutsui13, Koichi Takaguchi13, Tetsu Tomonari14, Shinichiro Nakamura15, Takakazu Nagahara16, Atsushi Hiraoka17, Tomomitsu Matono18, Masahiko Koda19, Mari Mandai20, Tomohiko Mannami21,22, Akeri Mitsuda23, Takashi Moriya24, Kazuhisa Yabushita25, Joji Tani1, Takahito Yagi26, Takahiro Yamasaki1,26. 1. aDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. 2. cDepartment of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan. 3. dDivision of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan. 4. eDivision of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Kagawa, Japan. 5. fDivision of Gastroenterology and Hepatology, Okayama City Hospital, Okayama, Japan. 6. gDepartment of Gastroenterology, Hiroshima Prefectural Hospital, Hiroshima, Japan. 7. hDivision of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital, Okayama, Japan. 8. iDepartment of Hepatology, Shimane University Hospital, Shimane, Japan. 9. jDivision of Gastroenterology and Hepatology, Tokushima Prefectural Central Hospital, Tokushima, Japan. 10. kDivision of Gastroenterology and Hepatology, Matsuyama Red Cross Hospital, Ehime, Japan. 11. lDivision of Gastroenterology and Hepatology, Hiroshima Red Cross and Atomic Bomb Survivors Hospital, Hiroshima, Japan. 12. mDivision of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan. 13. nDepartment of Hepatology, Kagawa Prefectural Central Hospital, Kagawa, Japan. 14. oDepartment of Gastroenterology and Hepatology, Tokushima University Graduate School, Tokushima, Japan. 15. pDepartment of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan. 16. qDivision of Gastroenterology and Hepatology, Tottori Prefectural Kousei Hospital, Tottori, Japan. 17. rGastroenterology Center, Ehime Prefectural Central Hospital, Ehime, Japan. 18. sDivision of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Tottori, Japan. 19. tDepartment of Internal Medicine, Hino Hospital, Tottori, Japan. 20. uDivision of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan. 21. vDivision of Gastroenterology and Hepatology, Chugoku Central Hospital, Hiroshima, Japan. 22. wDepartment of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan. 23. xDivision of Gastroenterology and Hepatology, Tottori Red Cross Hospital, Tottori, Japan. 24. yDivision of Gastroenterology and Hepatology, Chugoku Rousai Hospital, Hiroshima, Japan. 25. zDivision of Internal Medicine, Fukuyama City Hospital, Hiroshima, Japan. 26. bDepartment of Oncology and Laboratory, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Abstract
INTRODUCTION: Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is considered a safe and minimally invasive procedure. We previously reported that the mortality and complication rates for RFA were 0.038% (5/13,283 patients) and 3.54% (579 complications/16,346 procedures), respectively, from 1999 to 2010 (previous period). In this study, we investigated the clinical criteria for RFA and the mortality and complication rates from 2011 to 2015 (recent period). METHODS: Data were collected from 25 centers by using a questionnaire developed by the Chugoku-Shikoku Society for Local Ablation Therapy of HCC. The criteria for RFA, RFA modification, use of image-guidance modalities, mortality, and complications during the previous and recent periods were compared. RESULTS: We evaluated 11,298 procedures for 9,411 patients, including those that involved new devices (bipolar RFA and internally adjustable electrode system). The criterion of hepatic function for RFA increased from a Child-Pugh score ≤8 during the previous period to ≤9 during the recent period. The criteria regarding the tumor location and other risk factors have been expanded recently because of the increased use of several modifications of the RFA procedure and image-guidance modalities. The mortality rate was 0.064% (6/9,411 patients), and the complication rate was 2.92% (330 complications/11,298 procedures). There was no difference in mortality rates between the 2 periods (p = 0.38), but the complication rates was significantly lower during the recent period (p = 0.038). DISCUSSION AND CONCLUSIONS: Our findings confirmed that RFA, including the use of new devices, is a low-risk procedure for HCC, despite the expansion of the criteria for RFA during the recent period.
INTRODUCTION: Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is considered a safe and minimally invasive procedure. We previously reported that the mortality and complication rates for RFA were 0.038% (5/13,283 patients) and 3.54% (579 complications/16,346 procedures), respectively, from 1999 to 2010 (previous period). In this study, we investigated the clinical criteria for RFA and the mortality and complication rates from 2011 to 2015 (recent period). METHODS: Data were collected from 25 centers by using a questionnaire developed by the Chugoku-Shikoku Society for Local Ablation Therapy of HCC. The criteria for RFA, RFA modification, use of image-guidance modalities, mortality, and complications during the previous and recent periods were compared. RESULTS: We evaluated 11,298 procedures for 9,411 patients, including those that involved new devices (bipolar RFA and internally adjustable electrode system). The criterion of hepatic function for RFA increased from a Child-Pugh score ≤8 during the previous period to ≤9 during the recent period. The criteria regarding the tumor location and other risk factors have been expanded recently because of the increased use of several modifications of the RFA procedure and image-guidance modalities. The mortality rate was 0.064% (6/9,411 patients), and the complication rate was 2.92% (330 complications/11,298 procedures). There was no difference in mortality rates between the 2 periods (p = 0.38), but the complication rates was significantly lower during the recent period (p = 0.038). DISCUSSION AND CONCLUSIONS: Our findings confirmed that RFA, including the use of new devices, is a low-risk procedure for HCC, despite the expansion of the criteria for RFA during the recent period.
Authors: Teresa Marzia Rogger; Andrea Michielan; Sandro Sferrazza; Cecilia Pravadelli; Luisa Moser; Flora Agugiaro; Giovanni Vettori; Sonia Seligmann; Elettra Merola; Marcello Maida; Francesco Antonio Ciarleglio; Alberto Brolese; Giovanni de Pretis Journal: World J Gastroenterol Date: 2020-09-21 Impact factor: 5.742