Korean J Hepatol.  2006 Mar;12(1):55-64.

Clinical Features of Liver Abscess Developed after Radiofrequency Ablation and Transarterial Chemoembolization for Hepatocellular Carcinoma

• Kim MH
• Choi MS
• Choi YS
• Kim DY
• Lee JM
• Paik SW
• Lee JH
• Koh KC
• Yoo BC
• Choi D
• Rhee JC

Abstract

BACKGROUND/AIMS: Radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) have been applied for treating hepatocellular carcinoma (HCC), but procedure-related complications can be a serious problem. This study was conducted to evaluate the clinical features of HCC patients who developed liver abscess after RFA and TACE, as compared to those patients without malignancy. METHODS: In our center, from December 1999 to March 2004, 31 cases of liver abscess developed after local treatment of HCC (13/751 after RFA and 18/8417 after TAE), which correspond to 5.1% of the total cases (602) of liver abscess. We evaluated the patients' clinical features, the abscess characteristics, the bacteriology, treatment modality, hospital days and mortality, as compared to those characteristics of 263 abscess patients without malignancy. RESULTS: The time required to diagnose liver abscess was longer in the TACE group (24.8+/-16.5 days) compared to that of the other two groups (12.2+/-9.0 days in the RFA group, 9.6+/-7.5 days in the controls, P=0.001). Gas-forming liver abscess is most frequently found in the RFA groups (76.9%). There were more hospitalized days for the TACE groups than for the RFA group and the controls (34.7+/-19.8 vs. 15.2+/-9.2 vs. 18.6+/-10.9 days, respectively, P<0.001). Two patients (11%) in the TACE group died of sepsis and liver failure. CONCLUSIONS: For the patients with prolonged fever after RFA and especially after TACE for HCC, a diagnosis of liver abscess should be suspected earlier to reduce the morbidity and mortality due to liver abscess per se and also the sepsis-related decompensation of the liver.

Keyword

Catheter ablation; radiofrequency; Chemoembolization; therapeutic; Hepatocellular carcinoma; Complications; Liver abscess

MeSH Terms

Middle Aged
Male
Liver Neoplasms/surgery/*therapy
Liver Abscess/diagnosis/*etiology/microbiology
Humans
Female
Chemoembolization, Therapeutic/*adverse effects
Catheter Ablation/*adverse effects
Carcinoma, Hepatocellular/surgery/*therapy
Aged
Adult