Impact of thrombocytopenia on radiofrequency ablation therapy of hepatocellular carcinoma in patients with liver cirrhosis

ObjectiveThe objective of our study was to assess the impact of thrombocytopenia on percutaneous radiofrequency ablation (RFA) therapy of Hepatocellular carcinoma (HCC) in patients with liver cirrhosis.Material and methodsWe analyzed retrospectively 64 patients with liver cirrhosis and thrombocytopenia, defined as a platelet count of less than 100 × 103/mm3 that had undergone percutaneous RFA to treat 86 HCCs. The Kaplan–Meier and Cox regression methods were used to predict hemorrhage, and time to the first decompensation event, defined as the development of ascites, hepatic encephalopathy, variceal hemorrhage, and deterioration of liver function to Child-Pugh class B/C.ResultsThere were no significant risk factors of hemorrhage. Univariate and multivariate analyses revealed that liver decompensation was clearly linked to prothrombin activity (p = 0.010 and p = 0.006, respectively) and a ⩽ 63% of prothrombin activity was found as significant threshold for the occurrence of liver decompensation (p = 0.003) confirmed by the Cox model (p = 0.05).ConclusionPercutaneous RFA for HCC can be performed safely without the need for support, in patients with liver cirrhosis and thrombocytopenia up to 37 × 103/mm3.