Artificial Pleural Effusion and Ascites in Radiofrequency Ablation for Elderly Patients with Hepatocellular Carcinoma

  • Atsushi Hiraoka, Gastroenterology, Ehime Prefectural Central hospital, Japan
  • Takahide Uehara, Gastroenterology, Ehime Prefectural Central hospital, Japan
  • Satoshi Hidaka, Gastroenterology, Ehime Prefectural Central hospital, Japan
  • Aki Hasebe, Gastroenterology, Ehime Prefectural Central hospital, Japan
  • Soichi Ichikawa, Gastroenterology, Ehime Prefectural Central hospital, Japan
  • Yasunao Miyamoto, Gastroenterology, Ehime Prefectural Central hospital, Japan
  • Tomoyuki Ninomiya, Gastroenterology, Ehime Prefectural Central hospital, Japan
  • Kojiro Michitaka, Gastroenterology, Ehime Prefectural Central hospital, Japan

    • Background/Aim: Artificial pleural effusion and/or ascites have been used in radiofrequency ablation therapy (RFA) for patients with hepatocellular carcinoma (HCC) next to lung and gastrointestinal tract. Recently, elderly patients have been increased in Japan and have been treated same manner as younger if they have good performance status (PS). We assessed the safety of artificial pleural effusion and ascites in elderly HCC, retrospectively.
    Methods: Eighty six patients who were treated with RFA against HCC from January 2000 to December 2008 and were divided into elderly group (>=75 years old, n=27) and non-elderly group, (<75, n=59), and compared their clinical data, complications and local recurrence rate were analyzed.
    Results: Age and the level of alpha fetoprotein (AFP) were higher in elderly group as compared to non-elderly group (79.0 ± 2.6 vs. 65.3 ± 7.1 years, 579.5 ± 4786.6 vs. 125.0 ± 411.2 mAU/ml: P<0.01 and P=0.02, respectively). There were no significant differences for Child-Pugh class, tumor size, hospital days and in local recurrence rates after 1, and 2 years between the groups (elderly group vs non-elderly group: 0% and 10.0% vs. 8.5% and 18.9%; P=0.575). As for complications, there was no severe complication in elderly group while 1 of hemothorax and 1 of pneumothorax were observed in non-elderly.
    Conclusions: Artificial pleural effusion and ascites could be used safe and in same manner as non-elderly patients in RFA procedure for elderly HCC.