scholarly journals Infectious complications related to radiofrequency ablation of liver tumors: The role of antibiotics

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259641
Author(s):  
Ryo Nakagomi ◽  
Ryosuke Tateishi ◽  
Shintaro Mikami ◽  
Taijiro Wake ◽  
Mizuki Nishibatake Kinoshita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Radiofrequency Ablation ◽  
Liver Tumors ◽  
Infectious Complications ◽  
Prophylactic Antibiotics ◽  
Tumor Diameter ◽  
Single Administration ◽  
Continuous Administration ◽  
Administration Protocol

Background and aim Prophylactic administration of antibiotics within 24 hours of surgery is recommended to reduce the risk of infection. We conducted a prospective study to compare the efficacy of single administration of antibiotics with a historical control of continuous administration of antibiotics for radiofrequency ablation (RFA) of malignant liver tumors. Methods Between February 1, 1999 and November 30, 2010, a total of 6,763 RFA treatments were performed in 2,355 patients, using a protocol with continuous administration of prophylactic antibiotics. On December 1, 2010, we began using a revised protocol with a single administration of prophylactic antibiotics, while continuing to use the old continuous administration protocol for patients who declined the new protocol. Interim analysis was performed to assess the safety of the single administration protocol. Thereafter, from April 1, 2012, all patients were treated using the new protocol. Risk factors for infectious complications of RFA were assessed using logistic regression. Results From December 2010 to March 2012, 766 RFA treatments were performed in 663 patients using the new antibiotic protocol. Infectious complications were observed following 4 of these treatments (0.52%). As the upper limit of the confidence interval (CI) resulting from a one-sided binomial test was exactly the prespecified limit of 1.0%, from April 2012 onwards, we treated all patients using the new protocol with single administration of prophylactic antibiotics. A total of 3,547 RFA treatments were performed using the single administration protocol. Univariable logistic regression indicated that prior transcatheter arterial chemoembolization (TACE) and maximal tumor diameter were significant risk factors for infectious complications (P = 0.04 and P < 0.001, respectively). Multivariable analysis indicated that the adjusted hazard ratio of single vs. continuous administration of antibiotics was 1.20 (95% CI: 0.53–2.75; P = 0.66). Conclusions The rate of infectious complications related to RFA was acceptably low. Single administration of prophylactic antibiotics did not significantly increase the rate of infectious complications related to RFA, compared with a more intensive antibiotic protocol.

W1789 Risk Factors for Hemorrhagic Complications After Radiofrequency Ablation Therapy for Liver Tumors

2009 ◽  
Vol 136 (5) ◽  
pp. A-862
Author(s):  
Eriko Goto ◽  
Ryosuke Tateishi ◽  
Shuichiro Shiina ◽  
Kenichiro Enooku ◽  
Takahisa Sato ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiofrequency Ablation ◽  
Liver Tumors ◽  
Ablation Therapy ◽  
Hemorrhagic Complications ◽  
Radiofrequency Ablation Therapy

scholarly journals Perinatal characteristics associated with mortality and weight in patients with Omphalocele and Gastroschisis

2020 ◽  
Author(s):  
Alonso Herrera-Tasiguano ◽  
Katherine Figueroa ◽  
María-José Páez ◽  
Linda Arturo ◽  
Santiago Vasco-Morales
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Birth Weight ◽  
Abdominal Wall ◽  
Infectious Complications ◽  
Perinatal Risk Factors ◽  
Low Weight ◽  
Embryonic Origin ◽  
Epidemiological Profile ◽  
Associated Risk Factors

The study of abdomen-wall malformations corresponds almost exclusively to omphalocele and gastroschisis, despite their different embryonic origin, studies of the associated risk factors should be performed. The objective of this study was to compare the perinatal risk factors that in uence mortality and birth-weight in patients with omphalocele and gastroschisis, using Bayesian analogues of the t-test, ANOVA, and logistic regression. The data were obtained from the Perinatal Computer System of the Hospital Gineco-Obstétrico Isidro Ayora. From January 2009 to December 2018, 68 patients with gastroschisis and 18 with omphalocele were found, with a rate of 7.7 and 2 per 10,000 live newborns. Patients with omphalocele had a better birth weight, gastroschisis, occurs in young mothers. In both conditions mortality is associated with low weight, malformations or comorbidities in the first twelve days and respiratory and infectious complications after thirty days. The epidemiological profile of patients with abdominal wall malformations does not show signi cant differences with what was reported in other populations.

Hemobilia after CT-guided radiofrequency ablation of liver tumors: frequency, risk factors, and clinical significance

2018 ◽  
Vol 44 (1) ◽  
pp. 337-345 ◽  
Author(s):  
Mei-Fang Hsieh ◽  
Chia-Bang Chen ◽  
Yao-Li Chen ◽  
Chen-Te Chou
Keyword(s):  
Risk Factors ◽  
Radiofrequency Ablation ◽  
Clinical Significance ◽  
Liver Tumors ◽  
Ct Guided

scholarly journals Frequency and risk factors for major complications after stereotactic radiofrequency ablation of liver tumors in 1235 ablation sessions: a 15-year experience

2020 ◽  
Author(s):  
Peter Schullian ◽  
Edward Johnston ◽  
Gregor Laimer ◽  
Daniel Putzer ◽  
Gernot Eberle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Complication Rate ◽  
Tumor Size ◽  
Liver Tumors ◽  
Major Complication ◽  
Major Complications ◽  
History Of ◽  
Major Complication Rate ◽  
Simple Logistic

Abstract Objectives To assess the frequency of major complications after multi-probe stereotactic radiofrequency ablation (SRFA) in a large cohort of patients over 15 years and to elucidate risk factors for adverse events. Materials and methods A retrospective study was carried out between July 2003 and December 2018. Seven hundred ninety-three consecutive patients (median 65.0 years (0.3–88), 241 women and 552 men, were treated in 1235 SRFA sessions for 2475 primary and metastatic liver tumors with a median tumor size of 3.0 cm (0.5–18 cm). The frequency of major complications was evaluated according to SIR guidelines and putative predictors of adverse events analyzed using simple and multivariable logistic regression. Results Thirty-day mortality after SRFA was 0.5% (6/1235) with an overall major complication rate of 7.4% (91/1235). The major complication rate decreased from 11.5% (36/314) (before January 2011) to 6.0% (55/921) (p = 0.001). 50.5% (46/91) of major complications were successfully treated in the same anesthetic session by angiographic coiling for hemorrhage and chest tube insertion for pneumothorax. History of bile duct surgery/intervention, number of coaxial needles, and location of tumors in segment IVa or VIII were independent prognostic factors for major complications following multivariable logistic regression analysis. Simple logistic regression revealed the number of tumors, tumor size, location close to the diaphragm, tumor conglomerate, and segment VII as other significant predictors. Conclusion SRFA of liver tumors is safe and can extend the treatment spectrum of conventional RFA. Adaptations over time combined with increasing experience resulted in a significant decrease in complications. Key Points • In 1235 ablation sessions in 793 patients over 15 years, we found a mortality rate of 0.5% (6/1235) and an overall major complication rate of 7.4%, which fell from 11.5 (36/314) to 6.0% (55/921, p = 0.001) after January 2011, likely due to procedural adaptations. • History of bile duct surgery/intervention (p = 0.013, OR = 3.290), number of coaxial needles (p = 0.026, OR = 1.052), and location of tumors in segment IVa (p = 0.016, OR = 1.989) or VIII (p = 0.038, OR = 1.635) were found to be independent prognostic factors. • Simple logistic regression revealed that number of tumors, tumor size, location close to the diaphragm, tumor conglomerates, and segment VII were other significant predictors of major complications.

Development and Validation of a Novel Nomogram to Predict Lymph Node Involvement in T1 Stage Lung Adenocarcinoma.

2020 ◽  
Author(s):  
Jianjun Wang ◽  
Li Wei ◽  
Jiwei Li ◽  
Quan Zhang ◽  
Zeheng Ma
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Lymph Node ◽  
Lung Adenocarcinoma ◽  
Bootstrap Method ◽  
Significant Risk ◽  
Lymph Node Involvement ◽  
Tumor Diameter ◽  
Multivariate Logistic Regression ◽  
Lymph Node Swelling

Abstract A total of 326 patients with T1 lung adenocarcinoma from March 2012 to April 2016 in our center were included. The relationship between LNI and different risk factors were accessed by univariate and multivariate logistic regression analyses. Four significant risk factors identified by multivariate logistic regression were tumor diameter (OR = 2.175, 95%CI:1.277–3.072, p = 0.0045), lymph node swelling exist preoperative (OR = 6.144, 95%CI:6.947–14.059, p = 0.003), platelet to lymphocyte ratio (OR = 3.149, 95%CI:1.546–6.673, p = 0.003), CEA (OR = 4.375, 95%CI: 2.613–7.537, p = 0.00694). A nomogram was constructed by combing risk factors and validated with an internal set. The C-index of this nomogram was 0.875, which was validated by bootstrap method. At last we concluded that the novel nomogram showed the potential value of LNI prediction for lung adenocarcinoma.

Prediction of nodal metastasis in clinical T1 gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 21-21
Author(s):  
Hirohito Fujikawa ◽  
Kentaro Sakamaki ◽  
Taiichi Kawabe ◽  
Tsutomu Hayashi ◽  
Toru Aoyama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Logistic Regression ◽  
Predictive Accuracy ◽  
Significant Risk ◽  
Nodal Metastasis ◽  
Cancer Center ◽  
Tumor Diameter ◽  
Pathological Type ◽  
Undifferentiated Type

21 Background: Clinical T1 gastric cancer sometimes metastasizes to regional lymph nodes. Standard surgery is D2 gastrectomy for clinical T1N+ gastric cancer patients, however, clinical detection of nodal metastasis by Computed Tomography is unreliable, with only 4% sensitivity in our previous study. The present study aimed to predict pathological nodal metastases in clinical T1 gastric cancer. Methods: Patients were selected from the prospective database of Kanagawa Cancer Center between Oct 2000 and Oct 2007 based on the following criteria; (1) histologically proven adenocarcinoma of the stomach, (2) patients were diagnosed with clinical T1 by gastrointestinal endoscopy, (3) patients received radical surgery with D1 or more lymphadenectomy as a primary treatment. First, univariate logistic-regression model was used to select risk factors for prediction of pathological nodal metastasis by analyzing clinical factors of tumor location, clinical depth (cT1a or cT1b), macroscopic type, maximal tumor diameter, and pathological type. Then, the optimal cut-off value and predictive accuracy was determined by ROC curve using significant factors selected in logistic regression. Results: A total of 511 patients were entered into this study. Among these, pathological N+ was observed in 46 patients (9.0%). Clinical depth (p=0.002), tumor diameter (p<0.001) and pathological type (p=0.002) were significant risk factors for pathological nodal metastasis. Using these factors in multivariate logistic regression, the AUC was calculated to be 0.75. Cut-off value was different depending on the histology and clinical depth; 7.9 cm for differentiated type and 4.8 cm for undifferentiated type in cT1a and 4.3 cm for differentiated type and 1.1 cm for undifferentiated type in cT1b. Using these criteria, sensitivity and specificity for prediction of pathological nodal metastasis were 67.4% and 71.6%, respectively. Conclusions: Pathological nodal metastasis in clinical T1 gastric cancer was predictable by clinical depth, pathological type, and tumor size, however, specificity was not so high. D2 surgery is highly recommended for clinical T1 when the tumors satisfy these criteria.

scholarly journals Efficacy of microwave ablation versus radiofrequency ablation for hepatocellular carcinoma: a propensity score analysis

2021 ◽  
Author(s):  
Kanehiko Suwa ◽  
Toshihito Seki ◽  
Kazunori Aoi ◽  
Masao Yamashina ◽  
Miki Murata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Propensity Score ◽  
Microwave Ablation ◽  
Propensity Score Analysis ◽  
Major Complication ◽  
Therapeutic Effects ◽  
Tumor Diameter ◽  
Ablation Time

Abstract Purpose To evaluate the efficacy and safety of radiofrequency ablation (RFA) and new-generation microwave ablation (MWA) for the treatment of hepatocellular carcinoma (HCC). Methods The propensity score matching method was applied to patients with HCC treated with MWA (93 patients) or RFA (156 patients) at a single institution from January 2014 to April 2020. The local tumor progression (LTP), intrahepatic distant recurrence (IDR), and recurrence-free survival (RFS) of the two matched therapies were analyzed using the Kaplan–Meier method. Cox proportional hazard models were used to identify risk factors for LTP and RFS. The therapeutic effects and complications of the two treatments were also compared. Results The LTP, IDR, and RFS of MWA and RFA were equivalent (LTP: hazard ratio [HR] = 0.87; 95% confidence interval [95% CI] 0.36- 2.07; P = 0.746, IDR: HR = 1.03; 95% CI 0.61–1.73; P = 0.890, RFS: HR = 1.15; 95% CI 0.69–1.91; P = 0.566). Para-vessel lesions was the only risk factor for LTP, whereas age, previous treatment, Albumin-Bilirubin score, and tumor diameter were risk factors for RFS. On the other hand, the ablation time per nodule (6.79 ± 2.73 and 9.21 ± 4.90 min; P = 0.008) and number of sessions per nodule required to achieve technical success (1.16 ± 0.39 and 1.34 ± 0.57; P = 0.009) were significantly lower in MWA than in RFA. The major complication rate of MWA and RFA was also equivalent. Conclusion MWA and RFA have similar therapeutic effects and safety, although MWA has advantages over RFA regarding efficacy, including shorter ablation time and fewer sessions required.

Risk factors for endovenous heat-induced thrombosis after endovenous radiofrequency ablation of the great saphenous vein

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Raffaele Serra ◽  
Nicola Ielapi ◽  
Tiberio Rocca ◽  
Luca Traina ◽  
Stefano De Franciscis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein

Efficacy evaluation of the CEUS-LI-RADS-v2017 system in differential diagnosis of liver tumors

2019 ◽  
pp. 57-67
Author(s):  
A. N. Katrich ◽  
V. A. Porkhanov ◽  
N. S. Ryabin
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Liver Tumors ◽  
Morphological Data ◽  
Malignant Neoplasms ◽  
Diagnostic Efficiency ◽  
Efficacy Evaluation ◽  
General Group ◽  
Group 2 ◽  
Group 1

Objective: efficacy evaluation of the CEUS LI RADS v2017® system for differential diagnosis of liver tumors in patients with and without cirrhosis.Materials and methods. Retrospective analysis of diagnostic results of the 165 patients with liver tumors (177 nodules) was done. All patients underwent CEUS with results interpretation in accordance to the CEUS LIRADSv2017 ® criteria. Patients were divided into 2 groups based on clinical and morphological data. Group 1 included 62 patients with cirrhosis and/or CVH. Group 2 included 110 patients without risk factors for HCC.Results. Diagnostic efficiency of CEUS LI RADS v2017® for HCC identification was: group 1 – Se – 100%, Sp – 88%, Ac – 95.5%; group 2 – Se – 100%, Sp – 68.8%, Ac – 72.7%; general group Se – 100%, Sp – 72.2%, Ac – 81.4%. In the 2nd group, 21 out of 22 neoplasms, confirmed morphologically as FNH, we classified as LR 4. By applying benign character and specific contrasting patterns of FNG, they were transferred from LR 4 to LR 3. This allowed to increase sensitivity and specificity of differential diagnosis in group 2 (Se – 100%, Sp – 90.6%, Ac – 91.8%) and in general group (Se – 100%, Sp – 90.1%, Ac – 93.2%). Diagnostic efficiency of the criteria for non hepatocellular malignant neoplasms (LR M) was: group 1 – Se – 77.8%, Sp – 100%, Ac – 97%; group 2 – Se – 90%, Sp – 96.7%, Ac – 93.6%; general group- Se – 88.1%, Sp – 98.3%, Ac – 94.9%.Conclusion. Our study confirmed high accuracy of the CEUS LI RADS v2017® system in the differential diagnosis of focal liver tumors. Modification of the system (in particular, transfer of typical FNG forms from the LR 4 category) will make it possible to increase the accuracy of diagnostics by 20%. It will allow to use the LI RADS v2017® system for interpretation CEUS not only among patients with liver cirrhosis, but also in a general group without risk factors of GCC.

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