Retrospective Analysis of Chinese Patients with Hepatocellular Carcinoma (HCC) undergoing Transcatheter Arterial Chemoembolization (TACE) with or without Prophylactic Antibiotic Therapy

Chen, Jiu; Wu, Gang

doi:10.29271/jcpsp.2018.12.914

Cited by 8 publications

(3 citation statements)

References 10 publications

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“…The need for prophylactic use of antibiotics before c-TACE is consistent with the previous research results [ 18 , 28 , 29 ]. The risk factors for postoperative infection, such as diabetes history [ 19 ] and preoperative serum albumin level [ 15 ], are also consistent with previous studies.…”

Section: Discussionsupporting

confidence: 91%

Prophylactic Use of Antibiotics for Postsurgical Infection in c-TACE and DEB-TACE High-Risk Patients: A Case-Control Study

2022

Journal of Healthcare Engineering

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Objectives. According to recent reports, prophylactic use of antibiotics is not always required in conventional transarterial chemoembolization (c-TACE). However, clinical evidence of prophylactic antibiotics in drug-eluting beads transarterial chemoembolization (DEB-TACE) to prevent postsurgical infection is limited. This study is aimed to evaluate the correlation between the preoperative prophylactic application of antibiotics and postoperative infection in c-TACE or DEB-TACE, especially in a population with a high risk for postsurgical infection. Methods. In this retrospective study, TACE patients diagnosed with hepatic carcinoma (between January 2019 and May 2021) were examined. The case group was given 1.5 g cefuroxime sodium 0.5–1 hour before TACE, while there was no intervention in the control group. The outcomes analyzed were leukocyte count >9.5 × 109/L on the second day after the operation and the diagnosis of infection within one month after the operation. We applied univariate, multivariate logistic regression, trend analysis, and subgroup analysis to find potential risk factors and the necessity of prophylactic antibiotics. Results. Among 142 eligible cases, 72 received antibiotics while 70 were kept as control, 113 cases were treated with c-TACE, and 29 were treated with DEB-TACE. Multivariate analysis showed that the increase in white blood cell count after the operation was related to diabetes (OR 5.112, 95% CI 1.229–21.264, p = 0.025). The occurrence of postoperative infection was negatively correlated with preoperative albumin value (＜25 g/L) (OR 153.118, 95% CI 1.631–14372.331, p = 0.030). Trend analysis showed that the risk of postoperative infection increased with a decrease in serum albumin level (P < 0.05). Subgroup analysis showed that there were no significant differences in the incidence of increased leukocyte count and postoperative infection between the prophylactic and nonprophylactic treatment groups, in the case of diabetes, preoperative albumin levels, and operation mode (P > 0.1). Conclusions. Prophylactic antibiotic treatment before the c-TACE or DEB-TACE had no significant correlation with postoperative leukocyte increase and postoperative infection. Diabetes history and serum albumin levels were the prominent risk factors associated with an increase in postoperative leukocyte count and postoperative infection. Future large-scale studies and randomized-controlled trials are required to confirm and validate this association.

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Section: Discussionsupporting

confidence: 91%

Prophylactic Use of Antibiotics for Postsurgical Infection in c-TACE and DEB-TACE High-Risk Patients: A Case-Control Study

2022

Journal of Healthcare Engineering

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“…It has been shown that prophylactic antibiotics reduce the incidence of liver abscess formation in patients with bile duct injury (29,30). Moreover, previous studies have shown that the incidence of liver abscess formation does not increase among patients without bile duct injury who do not receive prophylactic antibiotics (30,31). Therefore, stratification according to risk factors is more reasonable for the administration of prophylactic antibiotics before TACE.…”

Section: Discussionmentioning

confidence: 99%

The impact of liver abscess formation on prognosis of patients with malignant liver tumors after transarterial chemoembolization

Wang,

Chang,

Zheng

et al. 2023

Front. Oncol.

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PurposeLiver abscess is a rare and serious complication after transarterial chemoembolization (TACE) for liver cancer; however, its impact on the prognosis is unclear. This retrospective study examined the outcomes of patients with liver abscess formation following TACE for malignant liver tumors to elucidate the impact of liver abscess formation on the prognosis of these patients.MethodsFrom January 2017 to January 2022, 1,387 patients with malignant tumors underwent 3,341 sessions of TACE at our hospital. Clinical characteristics of patients at baseline and follow-up were examined, including treatment and outcome of liver abscess, tumor response to the TACE leading to liver abscess, and overall survival time.ResultsOf 1,387 patients, 15 (1.1%) patients with liver abscess complications after TACE resulted in a total of 16 (0.5%) cases of liver abscess after 3,341 TACE sessions (including one patient with two events). After antibiotic or percutaneous catheter drainage (PCD) treatment, all the infections associated with liver abscesses were controlled. In the PCD group, eight patients died before drainage tube removal, one retained the drainage tube until the end of follow-up, and five underwent drainage tube removal; the mean drainage tube removal time was 149.17 ± 134.19 days. The efficacy of TACE leading to liver abscess was evaluated as partial response (18.75%), stable disease (37.5%), and progressive disease (43.75%). Eleven patients died during the follow-up period owing to causes unrelated to infections caused by liver abscesses. The survival rates at 3 months, 6 months, 1 year, and 5 years were 86.7%, 50.9%, 25.5%, and 17%, respectively.ConclusionPatients with liver abscess formation following TACE for malignant liver tumors experienced prolonged drainage tube removal time after PCD; while this condition did not directly cause death, it indirectly contributed to a poor prognosis in these patients.

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“…In the hepatologist survey, 49.1% of the respondents used prophylactic antibiotics for all or selected cases. Although small retrospective studies showed negative results, 26 , 27 a recent large-scale cohort with propensity score analysis demonstrated that prophylactic antibiotics reduced the occurrence of liver abscess following TACE by two-thirds. 28 …”

Section: Prophylactic Medications For Infection and Postembolization ...mentioning

confidence: 99%

Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association

Cho

Choi

Kwon

et al. 2023

JLC

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Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post- procedural patient care.

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Retrospective Analysis of Chinese Patients with Hepatocellular Carcinoma (HCC) undergoing Transcatheter Arterial Chemoembolization (TACE) with or without Prophylactic Antibiotic Therapy

Abstract: Objective: To assess the necessity of prophylactic antibiotic therapy in HCC patients undergoing transcatheter arterial chemoembolization (TACE).

Cited by 8 publications

References 10 publications

Prophylactic Use of Antibiotics for Postsurgical Infection in c-TACE and DEB-TACE High-Risk Patients: A Case-Control Study

Prophylactic Use of Antibiotics for Postsurgical Infection in c-TACE and DEB-TACE High-Risk Patients: A Case-Control Study

The impact of liver abscess formation on prognosis of patients with malignant liver tumors after transarterial chemoembolization

Transarterial chemoembolization for hepatocellular carcinoma: 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association

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