This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Risk of tumour seeding after percutaneous radiofrequency ablation for hepatocellular carcinoma. BJS 2005; 92: 856-858.
Published: 12th May 2005
Authors: T. Livraghi, S. Lazzaroni, F. Meloni, L. Solbiati
Background
A recent small study reported a high rate of neoplastic seeding after cooled‐tip radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) in patients who had undergone previous needle biopsy. Tumour seeding was associated with subcapsular tumour location, poorly differentiated tumours and a high α‐fetoprotein (AFP) level. The aim of the present study was to determine the rate of neoplastic seeding after RFA in a large series of unselected patients with HCC who had a long follow‐up.
Method
A total of 1314 patients with 2542 nodules were treated in three centres. Median follow‐up was 37 months. Needle biopsy had been performed before RFA in 241 patients (18·3 per cent). The influence of subcapsular location, high AFP level and previous biopsy on risk of tumour seeding was assessed.
Results
Neoplastic seeding was identified in 12 patients (0·9 per cent); the rate was comparable at the three centres (0·9, 0·7 and 1·4 per cent). Only previous biopsy was significantly associated with tumour seeding (P = 0·004).
Conclusion
RFA with a cooled‐tip needle was associated with a low risk of neoplastic seeding, even in unselected patients. The use of biopsy before RFA is to be discouraged, particularly when liver transplantation is a possibility at a later date. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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