Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2022; 10(24): 8535-8546
Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8535
Identification of predictive factors for post-transarterial chemoembolization liver failure in hepatocellular carcinoma patients: A retrospective study
Min Yuan, Tian-You Chen, Xiao-Rong Chen, Yun-Fei Lu, Jia Shi, Wen-Si Zhang, Chen Ye, Bo-Zong Tang, Zong-Guo Yang
Min Yuan, Tian-You Chen, Department of Interventional Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
Xiao-Rong Chen, Yun-Fei Lu, Jia Shi, Wen-Si Zhang, Chen Ye, Bo-Zong Tang, Zong-Guo Yang, Department of Integrative Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
Bo-Zong Tang, Department of Internal Medicine of Traditional Chinese Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 201200, China
Author contributions: Yang ZG and Tang BZ conceived and designed the study; Yuan M wrote the manuscript; Chen TY, Chen XR, Lu YF, Shi J, Zhang WS, Tang BZ, and Ye C analyzed and interpreted the data; Yang ZG and Tang BZ were responsible for revising the manuscript for important intellectual content; and all authors read and approved the final version.
Supported by Shanghai Science and Technology Committee, No. 19401931600; Shanghai Municipal Health Commission, No. 2020LZ001; and Health Commission of Pudong New District, Shanghai, No. PDZY-2021-0706.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee, Shanghai Public Health Clinical Center, Fudan University (approval No.2021-S062-01).
Conflict-of-interest statement: All the authors declare that there are no conflicts of interest related to this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo-Zong Tang, MD, PhD, Attending Doctor, Department of Internal Medicine of Traditional Chinese Medicine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Pudong New District, Shanghai 201200, China. tangbozong@shphc.org.cn
Received: March 23, 2022
Peer-review started: March 23, 2022
First decision: May 30, 2022
Revised: June 9, 2022
Accepted: July 16, 2022
Article in press: July 16, 2022
Published online: August 26, 2022
Processing time: 145 Days and 13.1 Hours
Abstract
BACKGROUND

Post-transarterial chemoembolization (TACE) liver failure occurs frequently in hepatocellular carcinoma (HCC) patients. The identification of predictors for post-TACE liver failure is of great importance for clinical decision-making in this population.

AIM

To investigate the occurrence rate and predictive factors of post-TACE liver failure in this retrospective study to provide clues for decision-making regarding TACE procedures in HCC patients.

METHODS

The clinical records of HCC patients treated with TACE therapy were reviewed. Baseline clinical characteristics and laboratory parameters of these patients were extracted. Logistic models were used to identify candidates to predict post-TACE liver failure.

RESULTS

A total of 199 HCC patients were enrolled in this study, and 70 patients (35.2%) developed post-TACE liver failure. Univariate and multivariate logistic models indicated that microspheres plus gelatin embolization and main tumor size > 5 cm were risk predictors for post-TACE liver failure [odds ratio (OR): 4.4, 95% confidence interval (CI): 1.2-16.3, P = 0.027; OR: 2.3, 95%CI: 1.05-5.3, P = 0.039, respectively]. Conversely, HCC patients who underwent tumor resection surgery before the TACE procedure had a lower risk for post-TACE liver failure (OR: 0.4, 95%CI: 0.2-0.95, P = 0.039).

CONCLUSION

Microspheres plus gelatin embolization and main tumor size might be risk factors for post-TACE liver failure in HCC patients, while prior tumor resection could be a favorable factor reducing the risk of post-TACE liver failure.

Keywords: Transarterial chemoembolization; Liver failure; Hepatocellular carcinoma; Embolization; Tumor size

Core Tip: Post-transarterial chemoembolization (TACE) liver failure occurs frequently in hepatocellular carcinoma (HCC) patients. Unfortunately, the incidence and risk factors for post-TACE liver failure are inconsistent worldwide. This study addressed the occurrence rate and potential risk factors for post-TACE liver failure according to a single-center retrospective report. The results of this study should attract the attention of relevant medical practitioners and provide predictive clues for the precise interventional treatment of HCC patients.