Risk factors of acute hepatic failure associated with transcatheter arterial chemoembolization for hepatocellular carcinoma.
- Author:
Yong Han PAIK
1
;
Chae Yoon CHON
;
Jae Yong CHO
;
Sang Hoon AHN
;
Kwan Sik LEE
;
Kwang Hyub HAN
;
Young Myoung MOON
;
Do Yeon LEE
;
Jong Tae LEE
Author Information
1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. cychon@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Carcinoma;
hepatocellular;
Chemoembolization;
therapeutic;
Liver failure;
acute;
Complications
- MeSH:
Aneurysm;
Bilirubin;
Carcinoma, Hepatocellular*;
Doxorubicin;
Femoral Artery;
Hearing Loss, Sensorineural;
Hemorrhage;
Hepatic Insufficiency;
Humans;
Infarction;
Korea;
Liver;
Liver Abscess;
Liver Failure;
Liver Failure, Acute*;
Multivariate Analysis;
Pneumonia;
Prognosis;
Prothrombin Time;
Retrospective Studies;
Risk Factors*;
Rupture;
Sepsis;
Thrombocytopenia;
Urinary Bladder;
Urticaria;
Venous Thrombosis
- From:Korean Journal of Medicine
2005;69(6):622-630
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Transcatheter Arterial Chemoembolization (TACE) has been the most widely used treatment for advanced hepatocellular carcinoma (HCC) in Korea. However a number of complications associated with TACE have been reported in many studies. Acute hepatic failure is one of the most serious complications of TACE, because of its grave prognosis. The aim of this study was to investigate the risk factors associated with acute hepatic failure after TACE. METHODS: A total of 263 TACE procedures performed in 163 patients with HCC were included in this study. We reviewed retrospectively the complications that occurred after TACE and analysed the risk factors associated with acute hepatic failure after TACE. RESULTS: Complications included post-embolization syndrome (187 cases), temporary hepatic insufficiency (90 cases), acute hepatic failure (13 cases), hepatic arterial injury (9 cases), intrahepatic biloma (4 cases), liver infarction (2 cases), liver abscess (2 cases), tumor rupture (1 cases), gastrointestinal bleeding (14 cases), septicemia (3 cases), gall bladder infarction (2 cases), thrombocytopenia (2 cases), gastric perforation (1 cases), pneumonia (1 cases), urticaria (1 cases), sensorineural hearing loss (1 cases), femoral artery aneurysm (1 cases). According to univariate analysis, risk factors associated with acute hapatic failure after TACE were serum bilirubin and albumin, prothrombin time, dose of adriamycin, pre-TACE Child-Pugh class, tumor size, diffuse tumor type, portal vein thrombosis and TNM stage. Multivariate analysis revealed that serum bilirubin {odd ratio=3.86 (95% CI: 1.59-9.32)}, and diffuse tumor type {odd ratio=5.29 (95% CI: 1.46-23.86)} were statistically significant risk factors. CONCLUSIONS: It is recommended that above mentioned risk factors should be considered carefully before TACE to prevent the occurrence of acute hepatic failure after TACE in HCC patients.
