Liver Failure After Transarterial Chemoembolization for Patients With Hepatocellular Carcinoma and Ascites

Hsin, I-Fang; Hsu, Chia-Yang; Huang, Hui‐Chun; Huang, Yi‐Hsiang; Lin, Hong-Da; Lee, Rheun‐Chuan; Chiang, Jen–Huey; Lee, Fa-Yauh; Huo, Teh–Ia; Lee, Shou‐Dong

doi:10.1097/mcg.0b013e318210ff17

Cited by 51 publications

(37 citation statements)

References 29 publications

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“…According to previous reports, TACE has been proved to significantly improve the survival rate in HCC patients . Whereas, accumulating evidence has demonstrated that TACE may lead to the irreversible deterioration of liver function as evaluated by the elevation of serum aminotransferases and the decrease of serum albumin (ALB), occasionally resulting in hepatic failure . Toxicity of chemotherapeutics drugs used in TACE has been suggested as the main cause of treat‐related complication .…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7] Whereas, accumulating evidence has demonstrated that TACE may lead to the irreversible deterioration of liver function as evaluated by the elevation of serum aminotransferases and the decrease of serum albumin (ALB), occasionally resulting in hepatic failure. [8][9][10] Toxicity of chemotherapeutics drugs used in TACE has been suggested as the main cause of treat-related complication. 11,12 Owing to selective uptake of the mixture of antineoplastic drugs and iodized oil by tumorous tissue, the side effects of TACE on peritumoral liver tissue are unlikely to be attributed by drug toxicity alone.…”

Section: Introductionmentioning

confidence: 99%

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Transarterial chemoembolization aggravated peritumoral fibrosis via hypoxia‐inducible factor‐1α dependent pathway in hepatocellular carcinoma

Yan

et al. 2015

J of Gastro and Hepatol

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transarterial chemoembolization aggravated peritumoral fibrosis via hypoxia‐inducible factor‐1α dependent pathway in hepatocellular carcinoma

Yan

et al. 2015

J of Gastro and Hepatol

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“…Hence there was no heterogeneity in terms of primary treatment due to the inclusion of patients with decompensated cirrhosis. The TACE was not recommended for patients with HCC and ascites due to a more vulnerable chance of the ischemic injury after TACE (31). However, the ascites variable was only one of the parameters that would have in uence on the survival.…”

Section: Discussionmentioning

confidence: 99%

Development of an ALBI and ascites based model to predict survival for BCLC Stage B hepatocellular carcinoma

Lin

Zheng

Yang

et al. 2020

Preprint

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Background: The outcome of the patients with BCLC stage B hepatocellular carcinoma (HCC) varied. Albumin-Bilirubin (ALBI) grade, as a surrogate of the Child-Pugh (CP) grade, was evaluated to be a simple tool for the assessing of the liver function and prognosis. However, it appears to be arbitrary and crude to eliminate the ascites variable from the ALBI grade. We aimed to develop a predictive model constituted with the ALBI grade, the ascites and tumor burden related parameters in patients with BCLC stage B HCC. Methods: Patients diagnosed as the BCLC stage B HCC were collected from a retrospective database. Construction and validation of the predictive model were performed based on multivariate Cox regression analysis. Predictive accuracy, discrimination and fitness performance of the model were compared with the other eight models. The decision curve analysis (DCA) was used to evaluate the clinical utility.Results: A total of 1773 patients diagnosed as BCLC stage B HCC between 2007 to 2016 were included in the present study. As the methods for the assessing of the liver function, the ALBI grade and ascites showed their independent prognostic value, and then the two parameters were combined into one, the ALBI-AS grade. Subsequently, the ALBI-AS grade (hazard ratio (HR)=1.26, p=0.008) along with two tumor burden related parameters (the AFP level and the 8-and-14 grade, p＜0.001) were used for the development of a prognostic prediction model after multivariate analysis. The area under the receiver operator characteristic curve (AUROC) for overall survival at 1, 2 and 3 years predicted by the present model were 0.73, 0.69 and 0.67 in the training cohort. The concordance index (c-index) and the Aiken information criterion (AIC) were 0.68 and 6216.3, respectively. In the internal and external validation cohorts, the present model still revealed excellent predictive accuracy, discrimination and fitness performance. Then the ALBI-AS based model was evaluated to be superior to other prognostic models with highest AUROC, c-index and lowest AIC values. Moreover, DCA also demonstrated that the present model was clinical beneficial. Additionally, participants could be classified into three distinct risk groups by the model.Conclusion: The ALBI-AS grade, as a pragmatic alternative of the ALBI grade, is a novel predictor of survival for patients with BCLC stage B HCC. The ALBI-AS based model was evaluated to be an accurate prognostic tool for individual prognostication, and performed well in terms of discrimination and fitness against other prognostic models. And it is appropriate to validate our findings on a larger prospective cohort.

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“…11,12 Hsin et al demonstrated that patients with post-TACE hepatic failure had a 2.13-fold increased risk of mortality, a majority of whom died within 12 months of TACE. 13 Likewise, if a HCC patient develops acute hepatic toxicity after SBRT and dies of liver failure within 12 months, it possibly may be due to negative effects of the preceding SBRT.…”

Section: Introductionmentioning

confidence: 99%

Influence of liver toxicities on prognosis after stereotactic body radiation therapy for hepatocellular carcinoma

Sanuki

Takeda

Oku

et al. 2014

Hepatology Research

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Liver Failure After Transarterial Chemoembolization for Patients With Hepatocellular Carcinoma and Ascites

Cited by 51 publications

References 29 publications

Transarterial chemoembolization aggravated peritumoral fibrosis via hypoxia‐inducible factor‐1α dependent pathway in hepatocellular carcinoma

Transarterial chemoembolization aggravated peritumoral fibrosis via hypoxia‐inducible factor‐1α dependent pathway in hepatocellular carcinoma

Development of an ALBI and ascites based model to predict survival for BCLC Stage B hepatocellular carcinoma

Influence of liver toxicities on prognosis after stereotactic body radiation therapy for hepatocellular carcinoma

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