Postembolization fever after transarterial chemoembolization is a sign of unfavorable therapeutic response in hepatocellular carcinoma patients

Abstract

Transarterial chemoembolization (TACE) is the standard of care for intermediate‐stage hepatocellular carcinoma (HCC) patients. The postembolization fever (PEF) is observed in 20% to 73% patients. This study aims to investigate the predictive factors of PEF and its impact on therapeutic response. From 2010 to 2015, a total of 525 HCC treatment naïve patients treated by TACE were recruited. Age, gender, etiologies of HCC, cirrhosis, tumor status, and pretherapy liver biochemistry were compared between patients with and without PEF. Predictors of PEF, complete response (CR), and progressive disease were analyzed by logistic regression. The PEF was observed in 185 patients (35.2%). The beyond up‐to‐seven, AST >2X upper limit of normal (ULN) and ALBI grade ≧2 were the independent predictors of PEF. Patients with PEF were less likely to achieve CR (18.4% vs 32.1%, P = .0017). Patients whose tumor burden beyond “up‐to‐seven” criteria with presence of tumor fever are least likely to achieve CR (aOR: 0.08, P = .022) and had higher risk for disease progression (aOR: 2.13, P = .082). PEF is related to heavier tumor burden and poorer liver reserve function. The presence of PEF is an unfavorable phenomenon correlating with poorer treatment response.

Benefits of stronger Neo‐Minophagen C in acute hepatitis after transarterial chemoembolization therapy for hepatomas

“…SNMC has been shown to have effects other than anti‐hepatotoxicity and anti‐inflammation, and this may reduce these subjective complaints 4 . Additionally, a study in Taiwan showed that post‐embolization fever after TACE is a sign of unfavorable therapeutic response in patients with HCC 13 . However, the tumor response to TACE was beyond our study design.…”

Radiological characteristics of hepatocellular carcinoma that achieved complete response after chemoembolization with drug-eluting beads for liver transplantation planning

“…A previous study reported that macrovascular invasion is a predictor of early HCC recurrence, whereas diabetes mellitus is a predictor of late HCC recurrence in patients with CR. (11) These parameters were not analyzed in the present study, but should also be considered as a tailored post-TACE follow-up strategy.…”

“…The impact of the initial tumor size on the time to relapse, maximum diameter reduction, and recurrence rates need to be explored. (11) This information is essential for patients undergoing neoadjuvant therapy, to better indicate DEB-TACE therapy in the pre-transplantation scenario based on real perspectives regarding HCC diameter reduction for downstaging and to establish better standards of radiological follow-up based on the average tumor recurrence time for patients undergoing bridge therapy. This could also potentially decrease the rate of exclusion from the liver transplantation waiting list (dropouts).…”

Impact of body composition on the prognosis of hepatocellular carcinoma patients treated with transarterial chemoembolization: A systematic review and meta-analysis

“…These findings were consistent with previous research [ 9 , 12 ]. Except these, treatment related factors have also shown to be closely correlated with the prognosis after TACE treatment, including number of TACE sessions [ 55 ], and response to TACE [ 56 ]. Furthermore, TACE may combine with other treatment options like tyrosine kinase inhibitors, radiofrequency ablation or immunotherapy, which also exerts significant effects on the treatment outcomes [ 57 ].…”