Efficacy of dexamethasone and N-acetylcysteine combination in preventing post-embolization syndrome after transarterial chemoembolization in hepatocellular carcinoma

Table 2 Comparison between patients based on the occurrence of post-embolization syndrome and liver decompensation after conventional transarterial chemoembolization

	PES after cTACE		P value	Liver decompensation after TACE		P value
	Yes (n = 43)	No (n = 57)		Yes (n = 7)	No (n = 93)
Male	40 (93%)	49 (86%)	0.26	7 (100%)	82 (88.2%)	0.34
Age (mean ± SD)	60.72 ± 11.11	60.56 ± 10.74	0.26	63.57 ± 7.91	60.41 ± 11.04	0.35
Child-Pugh score	5.35 ± 0.69	5.61 ± 0.9	0.09	5.86 ± 0.9	5.47 ± 0.82	0.24
A (5-6)	40 (93%)	43 (75.4%)	0.02	5 (71.4%)	78 (83.9%)	0.4
B (7-8)	3 (7%)	14 (24.6%)	0.02	2 (28.6%)	15 (16.1%)	0.4
ALBI (median; IQR)	-2.72 (-3.05, -2.29)	-2.65 (-2.93, -2.2)	0.47	-1.95 (-2.74, -1.77)	-2.69 (-3.04, -2.29)	0.09
MELD (mean ± SD)	11.67 ± 3.54	12.05 ± 3.78	0.61	12.71 ± 3.86	11.83 ± 3.66	0.54
Staging
BCLC-A	3 (7%)	6 (10.5%)	0.54	1 (14.3%)	8 (8.6%)	0.61
BCLC-B	40 (93%)	51 (89.5%)	0.54	6 (85.7%)	85 (91.4%)	0.61
Tumor characteristics
AFP ≥ 200 ng/mL	17 (39.5%)	27 (47.4%)	0.44	3 (42.9%)	28 (30.1%)	0.48
Median (range)	9.6 (4,13.2)	5 (3.2,10)	0.05	5.7 (3.2,15)	7 (3.2,13)	0.8
Large tumor ≥ 5 cm	29 (67.4%)	27 (47.4%)	0.045	4 (57.1%)	52 (55.9%)	0.95
Number
1	18 (41.9%)	22 (38.6%)	0.74	4 (57.1%)	36 (38.7%)	0.34
≥ 2	25 (58.1%)	35 (61.4%)		3 (42.9%)	57 (61.3%)
Size plus number
Up to 7	32 (74.4%)	37 (64.9%)	0.31	4 (57.1%)	65 (69.9%)	0.48
Up to 12	21 (48.8%)	15 (26.3%)	0.02	3 (42.9%)	33 (35.5%)	0.7
cTACE episode
1	15 (34.9%)	19 (33.3%)	0.87	4 (57.1%)	30 (32.3%)	0.18
≥ 2 (2-5)	28 (65.1%)	38 (66.7%)		3 (42.9%)	63 (67.7%)
Embolization agent
Mitomycin (mg)
< 10	2 (4.7%)	2 (3.5%)	0.44	0 (0%)	4 (4.3%)	0.51
10-15	10 (23.3%)	20 (35.1%)		1 (14.3%)	29 (31.2%)
15.1-20	31 (72.1%)	35 (61.4%)		6 (85.7%)	60 (64.5%)
Lipiodol (mL)
< 5	1 (2.3%)	1 (1.8%)	0.32	0 (0%)	2 (2.2%)	0.82
5-10	6 (14%)	15 (26.3%)		1 (14.3%)	20 (21.5%)
> 10	36 (83.7%)	41 (71.9%)		6 (85.7%)	71 (76.3%)
Level of embolization
Left hepatic artery	10 (23.3%)	18 (31.6%)	0.36	3 (42.9%)	28 (30.1%)	0.32
Right hepatic artery	38 (88.4%)	44 (77.2%)	0.15	7 (100%)	83 (89.2%)	0.37
Middle hepatic artery	1 (2.3%)	7 (12.3%)	0.07	0 (0%)	8 (8.6%)	0.43
1 vessel	37 (86%)	34 (59.6%)	0.004	3 (42.9%)	67 (72%)	0.25
≥ 2 vessels	6 (14%)	23 (40.4%)	0.007	4 (57.1%)	26(28%)	0.02
Baseline laboratory (median; IQR)
Hct (%)	36.8 (32.3, 40.3)	35 (32.6, 38.9)	0.33	39.8 (36.6, 40.6)	35.2 (32.2, 39)	0.04
WBC (× 109/L)	5.83 (4.50, 7.18)	5.48 (4.13, 6.97)	0.18	5.49 (4.14, 6.08)	5.58 (4.29, 7.07)	0.57
Platelet (× 109/L)	186 (125, 241)	144 (103, 204)	0.09	105 (65, 226)	171 (117, 230)	0.39
PTT (s)	12.9 (12.3, 13.8)	13.5 (12.7, 14.7)	0.02	13 (12.1, 13.2)	13.1 (12.4, 14.2)	0.34
AST (U/L)	51 (35, 102)	47 (37, 79)	0.78	163 (102, 169)	49 (36, 77)	0.003
ALT (U/L)	35 (20, 80)	33 (21, 51)	0.29	106 (80, 139)	31 (20, 51)	< 0.001
ALP (U/L)	124 (104, 290)	120 (93, 153)	0.211	290 (121, 386)	120 (94, 169)	0.111
Albumin (g/dL)	4 (3.6, 4.2)	3.9 (3.5, 4.2)	0.569	3.7 (3.2, 4.1)	3.9 (3.6, 4.2)	0.360
Total bilirubin (mg/dL)	0.59 (0.39, 1)	0.69 (0.51, 1.3)	0.163	1.59 (0.82, 2.11)	0.59 (0.42, 1.01)	0.005
Direct bilirubin (mg/dL)	0.35 (0.24, 0.65)	0.39 (0.26, 0.78)	0.415	0.91 (0.49, 1.76)	0.35 (0.24, 0.65)	0.004
Presence of PES, n (%)	-	-	-	7 (100%)	36 (38.7%)	0.002
Fever	40 (93.0%)	5 (8.8%)	< 0.001	7 (100%)	38 (40.9%)	0.002
Vomit	25 (58.1%)	2 (3.5%)	< 0.001	3 (42.9%)	24 (25.8%)	0.327
Pain	5 (11.6%)	0 (0.0%)	0.008	0 (0.0%)	5 (5.37%)	0.529
Anorexia	21 (48.8%)	2 (3.5%)	< 0.001	4 (57.1%)	17 (18.3%)	0.015

AFP: Alpha fetoprotein; ALBI: Albumin-bilirubin; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BCLC: Barcelona Clinic Liver Cancer; cTACE: Conventional transarterial chemoembolization; Hct: Hematocrit; IQR: Interquartile range; MELD: Model of end-stage liver disease; PES: Post-embolization syndrome; PTT: Prothrombin time; SD: Standard deviation; WBC: White blood cell.