Radiofrequency ablation of HCC on decompensated liver cirrhosis: Results and complications

Objectives: Radiofrequency (RF) ablation is used in the treatment of HCC on compensated cirrhosis. The aim of this study is to report results and complications of RF ablation of HCC in decompensated liver cirrhosis.

Methods: From January 2002 to July 2006 thirty-seven patients (28 males, 59–67 years) with 37 HCCs (diameter 2,3–4,7cm) and decompensated cirrhosis underwent percutaneous RF. All patients had ascites on ultrasound (US) and total bilirubin level ranged from 2,7 to 4,9mg/dl. The inclusion criteria were: refuse of liver transplantation, patients in waiting list or ineligibility for liver transplantation. RF was performed under US guidance using a perfused electrode needle introduced percutaneously and passing trough the ascites to reaching the HCC nodule. In 8 cases the nodule was located under liver surface.

Results: The duration time of RF ranged between 9 and 15 minutes. Three patients with subcapsular nodules showed blood spillage from the nodule after inserction of needle and stopped spontaneously after few seconds. These 3 patients were discharged 2 days later. Increased ascites was observed on US in 9 patients: in none of these cases US-guided puncture of abdomen fluid revealed haemoperitoneum. These patiens were discharged after 7–9 days. Seven patients showed increase in total bilirubin level from 2 to 3mg/dl compared to previous level which returned to normal value in 4–8 days. Overall survival rates were 100 and 72% at 3 and 5 years respectively.

Conclusions: Our results show that RF ablation of HCC is feasible even in decompensated cirrhosis in selected patients.