TRANS-TACE: Prognostic Role of the Transient Hypertransaminasemia after Conventional Chemoembolization for Hepatocellular Carcinoma

Abstract

The aim of the present study was to correlate laboratory data and postprocedural parameters after conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC) with the radiological response. The study consisted of a retrospective analysis of prospectively collected data from 70 consecutive patients who underwent cTACE. Laboratory parameters were assessed daily after cTACE and compared to pretreatment values. Post-treatment radiological response was assessed using mRECIST at one month from cTACE, and factors associated with treatment response (complete and objective response) were assessed by logistic regression analysis. The optimal cutoff points in predicting the complete response of target lesions were a 52% ALT and a 46% AST increase after cTACE compared to the pre-treatment values. Using multivariate analyses, >46% AST and >52% ALT increases with respect to the pre-treatment value were significantly correlated with the objective response (p = 0.03 and p = 0.04, respectively) and the complete response (p = 0.02 and p = 0.02, respectively). No patients experienced liver function deterioration after cTACE, and no specific treatment was required. This study showed that post-treatment transient transaminase elevation was predictive of objective response to superselective cTACE in clinical practice, representing a simple tool to guide treatment strategy of HCC patients in a tailored approach.

Apatinib Plus Camrelizumab With/Without Chemoembolization for Hepatocellular Carcinoma: A Real-World Experience of a Single Center

“…Moreover, the occurrence of adverse events can also predict patient prognosis. Granito et al (30) showed that post-treatment transaminase elevation predicted the objective response to TACE. The results regarding the management of adverse events with TACE+AC and its relationship with prognosis will be reported in our subsequent study.…”

Development and Validation of TACE Refractoriness-Related Diagnostic and Prognostic Scores and Characterization of Tumor Microenvironment Infiltration in Hepatocellular Carcinoma

“…found posttreatment transient transaminase elevation was predictive of objective response to superselective cTACE. But most other studies focus on radiological features or common tumor markers rather than specific biomarkers ( 52 ). Second, few studies focus on the relation between TACE refractoriness and HCC patient outcome, and developed predictors are primarily used for diagnosis rather than prognosis.…”

Prognostic Value of Aspartate Transaminase/Alanine Transaminase Ratio in Patients With Hepatitis B Virus-Related Hepatocellular Carcinoma Undergoing Hepatectomy

“…Thus, an elevated De Ritis ratio at baseline reflects tumor progression and deterioration of liver functional reserve. However, the transient elevation of serum transaminases in HCC patients after superselective transarterial chemoembolization was not accompanied by deterioration of liver functional reserve compared with baseline values but was secondary to tumor necrosis resulting in the release of large amounts of serum transaminases, reflecting a response to therapy ( 32 ).…”