1560. Infectious complications of Cryoablation/Microwave Ablation in Metastatic Solid Tumors
Session: Poster Abstract Session: Infections in the Immunocompromised Hosts
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA_cryosurgery.pdf (169.4 kB)
  • Background: Tumor ablative therapies like percutaneous cryoablation or microwave ablation have been developed to reduce tumor burden when surgical resection is not feasible.  Ablation can treat multiple lesions, save more uninvolved tissue with considerably minimal morbidity and the 5 year survival rate approaches that of surgical resection.  Infectious complications associated with ablative therapy have not been previously studied.

    Methods: This retrospective, cross-sectional study was conducted at the Karmanos Cancer Center. Patients who underwent cryoablations or microwave ablation for hepatic and/or renal tumors between January 1, 2003 and October 31, 2012 were included. Infectious complications occurring within 60 days of index procedure were recorded.

    Results: 377 Patients underwent tumor ablative procedures. 362 cryoablations, 15 microwave ablations were performed for 205 (54%) renal and 172 (46%) liver lesions. Mean age of the cohort was 63.5 ± 13 years, 196 (52%) were men and 201 (53%) were Caucasians. Seven (1.8%) patients developed infections; 6 of these (86%) had undergone cryoablations.  Two (28%) had liver abscess, 2 (28%) had renal abscess, 1 (15%) each had empyema, retroperitoneal and ventral hernia abscess with fistulous communication to the ablation site. Time to clinical infection was 37 days (IQR: 10-43). Five (71%) were polymicrobial infections, commonly due to skin and intestinal flora; 4 patients had concomitant bacteremia.  Six (86%) patients had pigtail catheters placed after the ablation procedure.  Two patients required intensive care unit admission but none died.  All patients were treated with abscess drainage and antibiotics.  

    Conclusion: Ablation procedures are commonly performed in patients with widespread metastatic solid tumors. Incidence rate for infectious complications in our cohort was 1.8%.  Polymicrobial infection due to skin or gut flora at ablation site and surrounding tissues was the most common infection noted.  Mortality from infection was low; most were successfully treated with drainage and antibiotics.

    Ashish Bhargava, MD, Detroit Medical Center (DMC) / Wayne State University, Detroit, MI, Harsha Vardhan Reddy Banavasi, MBBS, Wayne State University, Detroit, MI, Peter Littrup, Karmanos Cancer center, detroit, MI and Pranatharthi Chandrasekar, M.D., Infectious Diseases, Wayne State University, Detroit, MI

    Disclosures:

    A. Bhargava, None

    H. V. R. Banavasi, None

    P. Littrup, None

    P. Chandrasekar, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.