Int J Hyperthermia. 2017 Jun;33(4):454-458. doi: 10.1080/02656736.2017.1278630. Epub 2017 Jan 23.
Needle track seeding after percutaneous radiofrequency ablation of hepatocellular carcinoma: 14-year experience at a single centre.
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
Zhang Zhong-Yi, Yang Wei, Yan Kun, Dai Ying, Wu Wei, Lee Jung-Chieh, Chen Min-Hua
Affiliations
Affiliations
- a Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of ultrasound , Peking University Cancer Hospital and Institute , Beijing , China.
PMID: 28049374
DOI: 10.1080/02656736.2017.1278630
Abstract
PURPOSE: To determine the incidence, risk factors and prognosis associated with needle track seeding after percutaneous radiofrequency ablations (RFA) for hepatocellular carcinoma (HCC) with a long-term follow-up.
MATERIALS AND METHODS: A total of 741 HCC patients undergoing percutaneous RFA were retrospectively analysed. Mean follow-up interval was 34.3 ± 26.8 months. All seeding neoplasms were diagnosed by imaging modalities with or without pathological evaluation. Risk factors, including Child-Pugh grading, tumour size, number, location, serum alpha-fetoprotein (AFP) level, track number, biopsy before RFA and electrode type were performed by univariate analysis. Further therapy and survival of seeding after RFA were assessed. Survival analysis was analysed by Kaplan-Meier method.
RESULTS: Twelve patients (12 tumours) were diagnosed as seeding. It corresponds to an incidence of 1.6% (12/741) per patient and 0.9% (12/1341) per tumour. Seeding developed an average of 14.0 ± 8.1 months (6-33 months). Significant risk factors included tumour >3 cm (p = 0.031), subcapsular tumour (p = 0.031), biopsy before RFA (p = 0.001) and non-cool-tip electrode (p = 0.034). Eight patients received local therapy and four cases only received systematic therapy for uncontrolled advanced hepatic tumour or distal metastasis. Of eight patients receiving local therapy, one patient had local recurrence 16 months later and other seven patients did not have local recurrence for 3-73 months. The cumulative survival rates after seeding were 55.6%, 27.8%, 9.3% at 1, 3 and 5 years, respectively.
CONCLUSION: Needle track seeding is a rare delayed complication after percutaneous RFA. Tumour >3 cm, subcapsular tumour, biopsy before RFA and non-cool-tip electrode are potential risk factors for seeding. Local therapies are effective methods for seeding patients.
Keywords: Liver malignancy; complication; radiofrequency ablation; seeding
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