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RESEARCH PRODUCT

Predictive factors of transarterial chemoembolisation toxicity in unresectable hepatocellular carcinoma

Patrick HillonJean Louis JouveLudwig Serge AhoHéloïse AdamCyrille Di MartinoAnne MinelloLaurent BedenneGuiu BorisP. FagnoniJean-pierre CercueilMathieu BoulinCôme Lepage

subject

AdultLiver CirrhosisMalemedicine.medical_specialtyCarcinoma HepatocellularMultivariate analysisLogistic regressionGastroenterologyCohort StudiesHepatitis B ChronicLiver Cirrhosis AlcoholicRisk FactorsInternal medicinemedicineHumansIn patientAspartate AminotransferasesChemoembolization TherapeuticAdverse effectAgedRetrospective StudiesAged 80 and overHepatologybusiness.industryLiver NeoplasmsGastroenterologyRetrospective cohort studyAcute Kidney InjuryHepatitis C ChronicLiver Failure AcuteMiddle Agedmedicine.diseaseUniversity hospitalTumor BurdenSurgeryLogistic ModelsTreatment OutcomeDoxorubicinHepatic EncephalopathyHepatocellular carcinomaMultivariate AnalysisToxicityFemaleChemical and Drug Induced Liver InjuryIdarubicinbusiness

description

Abstract Background Transarterial chemoembolisation (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC), but can cause severe toxicity. Aim To identify predictive factors of severe TACE-related toxicity in patients with unresectable HCC. Methods All HCC patients who underwent TACE at the Dijon University Hospital between 2008 and 2011 were included in this retrospective study. Severe TACE-related toxicity was defined as the occurrence of any adverse event grade ≥4, or any adverse event that caused a prolongation of hospitalisation of >8 days, or any additional hospitalisation within 1 month after TACE. Factors predicting toxicity were identified using a logistic regression model. The robustness of the final model was confirmed using bootstrapping (500 replications). Results 124 patients were included, median age was 67 years and 90% were male; 22 patients (18%) experienced severe TACE-related toxicity. Factors that independently predicted severe TACE-related toxicity in multivariate analysis were total tumour size (OR, 1.15 cm −1 ; 95%CI, 1.04–1.26; p  = 0.01), and high serum AST levels (OR, 1.10 per 10 IU/l; 95%CI, 1.01–1.21; p  = 0.04). The results were confirmed by bootstrapping. Conclusions Total tumour size and high serum AST levels were predictive factors of severe TACE-related toxicity in this hospital-based series of patients with unresectable HCC.

https://doi.org/10.1016/j.dld.2013.12.012