Short-term reductions in non-protein respiratory quotient and prealbumin can be associated with the long-term deterioration of liver function after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma

2012 ◽  
Vol 47 (6) ◽  
pp. 704-714 ◽  
Author(s):  
Masaya Saito ◽  
Yasushi Seo ◽  
Yoshihiko Yano ◽  
Akira Miki ◽  
Masaru Yoshida ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Respiratory Quotient ◽  
Transcatheter Arterial Chemoembolization ◽  
Short Term ◽  
Arterial Chemoembolization

scholarly journals The feasibility of transcatheter arterial chemoembolization following radiation therapy for hepatocellular carcinoma

2021 ◽  
Vol 10 (7) ◽  
pp. 205846012110349
Author(s):  
Mostafa Hamada ◽  
Eisuke Ueshima ◽  
Takeaki Ishihara ◽  
Yutaka Koide ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Transcatheter Arterial Chemoembolization ◽  
Survival Duration ◽  
High Dose ◽  
Short Term ◽  
Liver Function Impairment ◽  
Function Impairment ◽  
Short Term Mortality ◽  
Arterial Chemoembolization

Background Technological developments have led to an increased usage of external-body radiotherapy (RT) for the treatment of hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) may be required later in patients treated with RT because of the high recurrence rate and multinodular presentation of HCC. However, despite the risk of liver function impairment, the cumulative liver damage correlated with TACE following a hepatic RT has not been adequately assessed. Purpose To evaluate the feasibility of TACE following RT for HCC. Materials and methods Sixty-seven patients with HCC who underwent TACE after RT were retrospectively evaluated between 2012 and 2018. We assessed increases in Child–Turcotte–Pugh (CTP) by ≥2 points at 1 month, the incidence of major complications, survival duration, and short-term mortality within 6 months after TACE. Furthermore, we evaluated the predictive factors for liver function impairment and short-term mortality. Results Eight patients experienced a CTP increase ≥2 points at 1 month. There were no cases of liver abscesses or bilomas. Nine patients died within 6 months following TACE. The mean liver dose (MLD) was a significant predictor of liver function impairment at 1 month ( p = 0.042). Low liver functional reserve, distant metastasis ( p = 0.037), MLD ( p = 0.046), TACE type ( p = 0.025), and TACE within 3 months following RT ( p = 0.007) were significant predictors of short-term mortality. Conclusions Despite the feasibility of TACE following RT, clinicians should pay attention to impaired pretreatment liver function, following high dose RT, and the short duration between RT and TACE.

Therapeutic Efficacy of Transcatheter Arterial Chemoembolization as Compared With Hepatic Resection in Hepatocellular Carcinoma Patients With Compensated Liver Function in a Hepatitis B Virus–Endemic Area: A Prospective Cohort Study

2002 ◽  
Vol 20 (22) ◽  
pp. 4459-4465 ◽  
Author(s):  
Hyo-Suk Lee ◽  
Kang Mo Kim ◽  
Jung-Hwan Yoon ◽  
Tae-Rim Lee ◽  
Kyung Suk Suh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Rate ◽  
Liver Function ◽  
Hepatic Resection ◽  
Transcatheter Arterial Chemoembolization ◽  
Survival Rates ◽  
Tumor Stage ◽  
Significant Difference ◽  
Tace Group ◽  
Arterial Chemoembolization

PURPOSE: Identifying a special subgroup of hepatocellular carcinoma (HCC) patients who may benefit from transcatheter arterial chemoembolization (TACE) when compared with the standard treatment of hepatic resection (HR) warrants research in Asian countries. PATIENTS AND METHODS: From January 1993 to December 1994, 182 patients with operable HCC (Child-Pugh class A and International Union Against Cancer [UICC] stage T1-3N0M0) were enrolled. After initial TACE and lipiodol computed tomography, 91 received HR and 91, who refused the operation, received repeated sessions of TACE. After stratification according to the tumor stage (UICC and Cancer of the Liver Italian Program [CLIP]) and lipiodol retention pattern, the survival rates of the two treatment groups were compared. The median follow-up period was 83 months. RESULTS: As of December 31, 2000, 48 patients who underwent HR and 68 patients who underwent TACE had died. In a subgroup analysis according to tumor stage, the HR group survival rate was significantly higher than the TACE group in both UICC T1-2N0M0 (P = .0058) and CLIP 0 (P = .0027) subgroups. However, there was no significant difference in either UICC T3N0M0 (P = .7512) or CLIP 1-2 (P = .5366) subgroups. Even in patients with UICC T1-2N0M0 HCC, when lipiodol was compactly retained, the survival rate of the HR group was comparable to that of the TACE group (P = .0596). CONCLUSION: TACE proved to be as effective as HR in the subpopulations with UICC T3N0M0 or CLIP 1-2 HCC and adequate liver function, and even with UICC T1-2N0M0 HCC when lipiodol was compactly retained in the tumor. In such cases, the choice of treatment modality between TACE and HR may be left to the patient’s preference.

scholarly journals The Combination of Albumin–Bilirubin Score and Prothrombin Time Is a Useful Tool for Predicting Liver Dysfunction after Transcatheter Arterial Chemoembolization in Child–Pugh Class A Patients with Hepatocellular Carcinoma within Up-to-Seven Criteria

2021 ◽  
Vol 10 (21) ◽  
pp. 4838
Author(s):  
Hiroaki Takaya ◽  
Tadashi Namisaki ◽  
Soichi Takeda ◽  
Kosuke Kaji ◽  
Hiroyuki Ogawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Prothrombin Time ◽  
Liver Dysfunction ◽  
Transcatheter Arterial Chemoembolization ◽  
Predictive Ability ◽  
Recurrence Rates ◽  
Class A ◽  
Pugh Class ◽  
Arterial Chemoembolization

Mortality and recurrence rates of hepatocellular carcinoma (HCC) are high. Recent studies show that for patients with HCC beyond up-to-seven criteria, treatment with molecular-targeted agents (MTAs) is recommended because the treatment efficiency of transcatheter arterial chemoembolization (TACE) is poor; further, TACE increases decline in liver function. However, the relationship between TACE and liver function decline in patients with HCC within up-to-seven criteria has not been clarified. Hence, we aimed to investigate this relationship. This retrospective observational study included 189 HCC tumors within up-to-seven criteria in 114 Child–Pugh class A patients. Twenty-four (12.7%) tumors were changed from Child–Pugh class A to B after TACE, and 116 (61.4%) tumors exhibited recurrence within 6 months after TACE. Prothrombin time (PT) and albumin–bilirubin (ALBI) score before TACE were significantly associated with liver dysfunction from Child–Pugh class A to B. The combination of PT and ALBI score before TACE had high predictive ability for liver dysfunction from Child–Pugh class A to B after TACE (specificity = 100%, sensitivity = 91.7%). The combined use of pre-TACE PT and ALBI score has a high predictive ability for liver dysfunction after TACE for Child–Pugh class A patients with HCC within up-to-seven criteria.

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