Abstract:
BACKGROUND:Ultrasound-guided percutaneous acetic acid injection (PAI) therapy is effective for hepatocellular carcinoma (HCC). Posttreatment fever (>37.5 degrees C) may occur owing to acetic acid-induced tumor necrosis, but its incidence and clinical significance are not clear. METHODS:A total of 402 treatment sessions in 127 consecutive patients undergoing PAI for HCC were prospectively studied. The incidence and risk factors associated with post-PAI fever were analyzed. RESULTS:There were 37 (9.2%) episodes of fever occurring in 29 HCC patients after PAI. Patients who developed fever more often had large-sized (3.5+/-1.3 cm vs. 2.7+/-1.2 cm, P=0.0002) tumor and a higher injection volume (2.6+/-0.1 mL vs. 2.2+/-0.1 mL, P=0.001) of acetic acid compared with those without fever. Multivariate logistic regression analysis showed that tumor size >3 cm was the only significant predictor associated with occurrence of posttreatment fever (odds ratio: 4.4, 95% confidence interval: 2.2-8.9, P<0.001). Three patients, all of whom had HCC diameter >3 cm, had 4 episodes of bacteremia after treatment; one of them developed liver abscess that required percutaneous drainage. CONCLUSIONS:Fever after PAI is not an uncommon event. Patients with tumor size >3 cm have a higher risk of posttreatment fever. Bacteremia and significant infectious complication could occur in a minority of patients. Prophylactic antibiotics before treatment may be necessary for high-risk patients.
journal_name
J Clin Gastroenteroljournal_title
Journal of clinical gastroenterologyauthors
Huo TI,Huang YH,Huang HC,Wu JC,Lee PC,Chang FY,Lee SDdoi
10.1097/00004836-200608000-00017subject
Has Abstractpub_date
2006-08-01 00:00:00pages
639-42issue
7eissn
0192-0790issn
1539-2031pii
00004836-200608000-00017journal_volume
40pub_type
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