Risk Factors for the Development of Postembolization Syndrome after Transarterial Chemoembolization for Hepatocellular Carcinoma Treatment

Lima, Mariana Zuliani Theodoro de; Dutra, Sofia; Gomes, Filipe Veloso; Bilhim, Tiago; Coimbra, Élia

doi:10.20344/amp.8976

Cited by 23 publications

(17 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No sources of data on blood vessel invasion as a risk factor for pain were found when conducting a literature review; thus, our study is the first in this respect, identifying blood vessel invasion as a predictor of pain. Tumor invasion of the portal vein is more common in the late stages of cancer[ 17 ], and is often accompanied by tumors that are large in size and/or numerous, which may be attributable to tumor necrosis and a more marked inflammatory response, which is caused by embolization of a larger site[ 18 - 20 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive model for acute abdominal pain after transarterial chemoembolization for liver cancer

Bian

Zhao

Gao

et al. 2020

WJG

View full text Add to dashboard Cite

BACKGROUND Transarterial chemoembolization (TACE) is the first-line treatment for patients with unresectable liver cancer; however, TACE is associated with postembolization pain. AIM To analyze the risk factors for acute abdominal pain after TACE and establish a predictive model for postembolization pain. METHODS From January 2018 to September 2018, all patients with liver cancer who underwent TACE at our hospital were included. General characteristics; clinical, imaging, and procedural data; and postembolization pain were analyzed. Postembolization pain was defined as acute moderate-to-severe abdominal pain within 24 h after TACE. Logistic regression and a classification and regression tree were used to develop a predictive model. Receiver operating characteristic curve analysis was used to examine the efficacy of the predictive model. RESULTS We analyzed 522 patients who underwent a total of 582 TACE procedures. Ninety-seven (16.70%) episodes of severe pain occurred. A predictive model built based on the dataset from classification and regression tree analysis identified known invasion of blood vessels as the strongest predictor of subsequent performance, followed by history of TACE, method of TACE, and history of abdominal pain after TACE. The area under the receiver operating characteristic curve was 0.736 [95% confidence interval (CI): 0.682-0.789], the sensitivity was 73.2%, the specificity was 65.6%, and the negative predictive value was 92.4%. Logistic regression produced similar results by identifying age [odds ratio (OR) = 0.971; 95%CI: 0.951-0.992; P = 0.007), history of TACE (OR = 0.378; 95%CI: 0.189-0.757; P = 0.007), history of abdominal pain after TACE (OR = 6.288; 95%CI: 2.963-13.342; P < 0.001), tumor size (OR = 1.978; 95%CI: 1.175-3.330; P = 0.01), multiple tumors (OR = 2.164; 95%CI: 1.243-3.769; P = 0.006), invasion of blood vessels (OR = 1.756; 95%CI: 1.045-2.950; P = 0.034), and TACE with drug-eluting beads (DEB-TACE) (OR = 2.05; 95%CI: 1.260-3.334; P = 0.004) as independent predictive factors for postembolization pain. CONCLUSION Blood vessel invasion, TACE history, TACE with drug-eluting beads, and history of abdominal pain after TACE are predictors of acute moderate-to-severe pain. The predictive model may help medical staff to manage pain.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictive model for acute abdominal pain after transarterial chemoembolization for liver cancer

Bian

Zhao

Gao

et al. 2020

WJG

View full text Add to dashboard Cite

show abstract

“…Although a previous study reported that elderly patients may have less pain after TACE than young patients, 13 whether age can influence post-TACE pain is rather controversial. 14,28 Thus, further prospective studies should be conducted to confirm this finding. Furthermore, the multivariate analysis in the present study using the CART algorithm showed similar risk factors and supported the findings from the ordinal logistic regression analysis.…”

Section: Discussionmentioning

confidence: 82%

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

Wang

Zhang

Xiao

2020

JPR

View full text Add to dashboard Cite

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.

show abstract

“…This complication is particularly common with a sufficient embolus, and it is caused by tumor necrosis ( 14 ). Major symptoms include fever, elevated ALT and aspartate transaminase levels, nausea, vomiting, and abdominal pain, though most cases resolve within a few days of symptom onset and with symptomatic treatment if necessary ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Transcatheter Arterial Embolization for the Initial Management of Intra-Abdominal Hemorrhage From a Hepatic Tumor in a Cat

et al. 2021

View full text Add to dashboard Cite

An 8-year-old Ragdoll cat was admitted to our hospital after its owner noticed sudden lethargy. Abdominal ultrasonography showed a large amount of blood in the abdominal cavity, and the cat was diagnosed as having hemorrhagic shock caused by the rupture of an intra-abdominal mass. Blood transfusion was performed on the 1st day of hospitalization. On the 2nd day, contrast-enhanced computed tomography (CT) was performed, and hemorrhage from a mass originating in the caudate lobe of the liver was noted. Transcatheter arterial embolization (TAE) was performed to stop the bleeding from the mass using Gelpart to embolize the feeding artery. The following day, fever and elevation of liver enzyme levels were observed, but these subsided within a few days. At discharge 5 days after TAE, no fluid was found in the peritoneal cavity, and no further intra-abdominal bleeding occurred. Sixty-six days after TAE, we were able to perform resection surgery with the cat in good condition. A partial response was observed on CT performed before surgery. Histopathology revealed cholangiocellular adenoma. The cat was doing well as of postoperative day 549. This case indicates that TAE may be effective for initial hemostasis and stabilization of conditions in animals with tumor-induced hemorrhage.

show abstract

Risk Factors for the Development of Postembolization Syndrome after Transarterial Chemoembolization for Hepatocellular Carcinoma Treatment

Cited by 23 publications

References 17 publications

Predictive model for acute abdominal pain after transarterial chemoembolization for liver cancer

Predictive model for acute abdominal pain after transarterial chemoembolization for liver cancer

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

Case Report: Transcatheter Arterial Embolization for the Initial Management of Intra-Abdominal Hemorrhage From a Hepatic Tumor in a Cat

Contact Info

Product

Resources

About