Clin Mol Hepatol Volume_18 Number_3 September 2012 Table 2. Risk factors contributing to the deterioration of liver function after radiofrequency ablation Univariate analysis Variables Odds ratio (95% CI) Sex (male) 1.63 (0.711-3.710) Age (≥75 years) 1.28 (0.303-5.404) Chronic hepatitis C 0.04 (0.000-3.450) Chronic hepatitis B 1.67 (0.459-6.056) Tumor number (single vs. multinodular) 1.44 (0.942-2.213) Ablation cycle (single vs. multiple) 2.63 (0.909-7.601) Ascites (yes) 0.99 (0.528-1.774) Child classification (A vs. B) 4.35 (1.906-9.946) Tumor size (≥2.0 cm) 1.07 (0.799-1.419) Ablation time (≥20 min) 1.05 (0.470-2.327) Child-Pugh score (≥9 points) 2.35 (0.889-6.202) pre-RFA platelet (≥70,000/mm3) 3.47 (1.625-7.418) pre-RFA albumin (≥3.5 g/dL) 5.21 (2.102-12.902) pre-RFA bilirubin (≥1.1 mg/dL) 3.37 (1.358-8.338) pre-RFA ALT (≥80 IU/L) 0.94 (0.223-3.969) pre-RFA AFP (≥100 mg/mL) 1.06 (0.464-2.421) Stepwise multivariate analysis Variables Odds ratio (95% CI) Tumor number (single vs. multinodular) 0.91 (0.397-2.102) Ablation cycle (single vs. multiple) 2.15 (0.721-6.387) Child classification (A vs B) 1.53 (0.450-5.205) Child-Pugh score (≥9 points) 1.245 (0.339-2.637) pre-RFA platelet (=70,000/mm3) 2.92 (1.325-6.430) pre-RFA albumin (=3.5 g/dL) 3.35 (0.868-12.928) RFA, radiofrequency ablation; ALT, alanine aminotransferase; AFP, alpha-fetoprotein. P value 0.250 0.737 0.155 0.438 0.092 0.074 0.916 <0.001 0.667 0.913 0.085 0.001 <0.001 0.009 0.933 0.890 P value 0.832 0.170 0.496 0.914 0.008 0.079 the production of inflammatory cytokines, such as interleukin (IL)- 1, IL-6, and transforming necrosis factor alpha.15 Such inflamma- tory cytokines not only stimulate the production of acute phase proteins including C-reactive protein, but also inhibit the synthesis of albumin.16 Third, serum albumin extravasated from the inflam- matory foci. Therefore, both inflammatory response and loss of normal liver volume account for decrease in serum albumin. Kota et al17 previously reported that alteration of liver function after percutaneous ethanol injection. The deterioration of the liver function was observed in only 9.6% of patients who underwent PEI or the combination of PEI and TACE. On the contrary, 34% of patients who underwent RFA or the combination of RFA and TAE showed deterioration of liver function. In present study, the deterioration of liver function was observed in 29 patients (28.4%). Although the present study did not compare the changes of liver function with control arms, the deterioration of liver function could be resulted from RFA procedure, not from progression of underlying liver disease.18 The platelet counts of patients ranged from 50,000/mm3 to 30,7000/mm3 and patients with platelet count less than 100,000/ mm3 were 45 (44.1%). Although platelet was transfused only in 5 patients with thrombocytopenia less than 60,000/mm3, there were no cases of bleeding as complication after RFA. Thrombocy- topenia is common in patients with chronic liver disease, reported in as many as 76% of cirrhotic patients.19 Among these cirrhotic patients, platelet count below 50,000/mm3 is observed in 1% of patients and this condition can significantly increase the risk of spontaneous bleeding such as cerebral hemorrhage or hemor- rhage from gastrointestinal sources.20,21 Many physicians require platelet counts of ≥80,000/mm3 to perform percutaneous liver 306 http://dx.doi.org/10.3350/cmh.2012.18.3.302 http://www.e-cmh.org