Georgios Velonakis MD, Presenter: Nothing to Disclose

Dimitrios Filippiadis MD, PhD, Abstract Co-Author: Nothing to Disclose

Maria Alkiviades Mademli MD, Abstract Co-Author: Nothing to Disclose

Katerina Malagari, Abstract Co-Author: Nothing to Disclose

Alexios Kelekis MD, PhD, Abstract Co-Author: Consultant, Benvenue Medical, Inc

Nikolaos L. Kelekis MD, Abstract Co-Author: Nothing to Disclose

To evaluate and compare post treatment pain in patients with HCC or metastatic liver lesions treated with surgery, percutaneous radiofrequency, or percutaneous microwave ablation.  

During 2 years, 103 patients treated for HCC or metastatic liver lesions were divided in three groups. 37 patients (Group A) underwent surgical operation (partial hepatectomy), 32 patients (Group B) underwent Computed Tomography (CT)-guided radiofrequency ablation (Leveen needle Radiofrequency electrode 5.0) and 34 patients (Group C) underwent CT-guided microwave ablation (16G Microwave probe). In Groups B and C ablation was performed under conscious sedation. Numeric Visual Scale questionnaire for pain was used to evaluate pain daily during follow-up. The required analgesics (type and dose) for all patients were recorded.

Mean pain duration post treatment was 10.76±2.80 days in Group A, 1.34±0.75 in Group B and 1.41±0.74 in Group C. Differences in mean pain duration between surgery and radiofrequency and between surgery and microwave ablation were 9.41 and 9.35 days respectively. These differences were statistically significant (p<0.001). There was no statistically significant difference in pain duration between Groups B and C. Mean pain score in Group A was 7.68±0.884 NVS units in day 1, 7.43±0.929 in day 2, 6.97±1.118 in day 3 and 6.35±1.086 NVS units in day 4. The respective pain scores in Group B were 1.66±1.894 in day 1, 0.66±0.865 in day 2, 0.03±0.177 in day 3 and 0 in day 4. In Group C mean pain scores were 1.97±1.838 NVS units in Day1, 0.62±0.817 in Day 2, 0.03±0.172 in day 3 and 0 in day 4. Differences in mean pain scores were statistically significant between surgery and percutaneous treatment for each of the 4 first days (p<0.001), but there was no statistically significant difference between radiofrequency and microwave ablation. No clinically significant complications were noticed.

Pain is an important complication post hepatic resection. Both image-guided percutaneous microwave ablation and radiofrequency ablation seem to be correlated with clinically insignificant pain post treatment as opposed to hepatectomy.  

Image guided percutaneous microwave ablation and radiofrequency ablation of HCC or metastatic liver lesions are correlated with minimal pain, and they can be easily tolerated even if repeated sessions are required.

Velonakis, G, Filippiadis, D, Mademli, M, Malagari, K, Kelekis, A, Kelekis, N, Comparative Study Evaluating Pain after Hepatectomy, Percutaneous Radiofrequency and Percutaneous Microwave Ablation in Patients with HCC or Metastatic Hepatic Lesions.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011383.html