Post‐embolization syndrome as an early predictor of overall survival after transarterial chemoembolization for hepatocellular carcinoma

Mason, Meredith C.; Massarweh, Nader N.; Salami, Aitua; Sultenfuss, Mark A.; Anaya, Daniel A.

doi:10.1111/hpb.12487

Cited by 57 publications

(49 citation statements)

References 47 publications

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“… 3 , 19 , 20 Prognosis was even worse in patients who developed severe complications after TACE. 21 In our study, the 3-year overall survival probability was 37.74% in the JLD group and 26.00% in the control group. The results of survival analysis in our study suggested that the JLD group had a significantly higher 3-year overall survival probability than the control group ( P =0.0365 by log-rank test).…”

Section: Discussionsupporting

confidence: 43%

Chinese herbal medicine, Jianpi Ligan decoction, improves prognosis of unresectable hepatocellular carcinoma after transarterial chemoembolization: a retrospective study

Tang¹,

Zhu²,

Feng³

et al. 2016

DDDT

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ObjectiveThis study aimed to investigate the efficacy of Jianpi Ligan decoction (JLD) as an adjuvant therapy for patients with unresectable hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE).MethodsFrom March 2007 to March 2013, 103 patients with unresectable HCC who underwent TACE in our center were included in this retrospective study. Among the 103 patients, 53 patients accepted JLD along with TACE (JLD group) and 50 patients accepted TACE alone (control group). Indices including complication, toxicity, treatment success rate, and long-term survival were obtained for analysis and comparison.ResultsThere was no significant difference in patient characteristics between the two groups. No procedure-related deaths or encephalopathy occurred. Fewer patients from the JLD group experienced constipation (7/53 vs 15/50, P=0.0377), abdominal bloating (5/53 vs 12/50, P=0.0466), and lack of appetite (35/53 vs 42/50, P=0.0360). The JLD group had lesser and lighter hepatic toxicity (P=0.0265) and gastrointestinal toxicity (P=0.0445) such as nausea and vomiting. The JLD group had a significantly higher treatment success rate than the control group (51/53 vs 40/50, P=0.0103). Three-year overall survival probability was significantly higher in the JLD group than in the control group (37.74% vs 26.00%; hazard ratio [HR] 0.6171; 95% confidence interval [CI], 0.3832–0.9938; P=0.0365 by log-rank test). No significant difference was found in 3-year overall survival probability (39.22% vs 32.50%; HR, 0.7449; 95% CI, 0.4398–1.2614; P=0.2491 by log-rank test) or 3-year intrahepatic recurrence-free survival probability in patients who achieved treatment success (37.25% vs 30.00%; HR, 0.7280; 95% CI, 0.4332–1.2233; P=0.2087 by log-rank test) between the two groups.ConclusionApplication of JLD was effective for reduction of side effects and improvement of long-term survival for patients with unresectable HCC treated by TACE.

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Section: Discussionsupporting

confidence: 43%

Chinese herbal medicine, Jianpi Ligan decoction, improves prognosis of unresectable hepatocellular carcinoma after transarterial chemoembolization: a retrospective study

Tang¹,

Zhu²,

Feng³

et al. 2016

DDDT

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“…Moreover, in a recent study, (8) the occurrence of PES was associated with worse survival after TACE. (8) Because this study was retrospective and was not designed with adequate stratification, the findings cannot be considered conclusive; nonetheless, this suggestion cannot be ignored given the potential detrimental effects of cytokines released during PES. Hence, a safe and effective prevention of PES occurrence after endovascular treatments for HCC would be of great benefit for the medical community, and most importantly for patients' quality of life.…”

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confidence: 89%

“…However, PES is not only an inconvenience for patients—which occasionally discourages subsequent TACE courses due to the threat of recurrence—but it often prolongs hospital stays, causes diagnostic dilemmas in case of fever and pain leading to additional diagnostic testing, and is therefore a burden for physicians and administrators. Moreover, in a recent study, the occurrence of PES was associated with worse survival after TACE . Because this study was retrospective and was not designed with adequate stratification, the findings cannot be considered conclusive; nonetheless, this suggestion cannot be ignored given the potential detrimental effects of cytokines released during PES.…”

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confidence: 89%

A new horizon in the prevention of the postembolization syndrome after transcatheter arterial chemoembolization for hepatocellular carcinoma

et al. 2017

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“…Third, we did not assess the relationship between the long-term outcomes of HCC patients and post-TACE pain. Although a previous study reported that postembolization syndrome is an early predictor of poor overall survival for patients with advanced and unresectable HCC, 29 the relationship between post-TACE pain and overall survival has not been well studied. We believe this correlation needs to be further studied and characterized.…”

Section: Discussionmentioning

confidence: 99%

<p>Determination of Risk Factors for Pain After Transarterial Chemoembolization with Drug-Eluting Beads for Hepatocellular Carcinoma</p>

Wang

Zhang

Xiao

2020

JPR

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Purpose: To identify risk factors for pain after transarterial chemoembolization with drugeluting beads (DEB-TACE) for hepatocellular carcinoma (HCC). Patients and Methods: In this retrospective study, a total of 118 consecutive patients who underwent DEB-TACE between June 2016 and May 2019 with post-TACE pain were included. The patients were divided into three groups based on the severity of post-TACE pain according to the distribution of pain Visual Analogue Scale/Score (VAS). Potential risk factors for post-TACE pain were primarily analyzed using the chi-square test, one-way analysis of variance, or Kruskal-Wallis test (if appropriate). For multivariate analysis, an ordinal logistic regression model was utilized. Variables with P<0.10 in the univariate analysis were included in a multivariate model to identify independent risk factors for post-TACE pain. A multivariate analysis was also performed by means of a decision tree using the Classification and Regression Tree (CART) algorithm. Results: The univariate analysis showed that elderly patients or patients with portal venous tumor thrombus (PVTT) were more likely to have severe post-TACE pain than young patients or those without PVTT (P=0.028 and <0.001, respectively). However, in the ordinal logistic regression, nonsuperselective chemoembolization and presence of PVTT were independent risk factors of severe post-TACE pain (P=0.046 and <0.001, respectively). In addition, the CART showed that nonsuperselective chemoembolization and PVTT could increase the probability of severe post-TACE pain. Conclusion: Nonsuperselective chemoembolization and PVTT are independent risk factors for pain after DEB-TACE. Therefore, these factors should be taken into full consideration for the relief of pain.

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Post‐embolization syndrome as an early predictor of overall survival after transarterial chemoembolization for hepatocellular carcinoma

Abstract: PES is a common complication after TACE and is associated with a two-fold increased risk of death. Future studies should incorporate PES as a relevant early predictor of OS and examine the biological basis of this association.

Cited by 57 publications

References 47 publications

Chinese herbal medicine, Jianpi Ligan decoction, improves prognosis of unresectable hepatocellular carcinoma after transarterial chemoembolization: a retrospective study

Chinese herbal medicine, Jianpi Ligan decoction, improves prognosis of unresectable hepatocellular carcinoma after transarterial chemoembolization: a retrospective study

A new horizon in the prevention of the postembolization syndrome after transcatheter arterial chemoembolization for hepatocellular carcinoma

<p>Determination of Risk Factors for Pain After Transarterial Chemoembolization with Drug-Eluting Beads for Hepatocellular Carcinoma</p>

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