Post-embolization syndrome as an early predictor of overall survival after transarterial chemoembolization for hepatocellular carcinoma
Meredith C. Mason
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
Search for more papers by this authorNader N. Massarweh
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
Search for more papers by this authorAitua Salami
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Search for more papers by this authorMark A. Sultenfuss
Department of Radiology, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Daniel A. Anaya
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
Correspondence
Daniel A. Anaya, Section of Hepatobiliary Tumours, Depart of GI Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive - FOB 2, Tampa, FL 33612, USA. Tel.: +1 813 745 6898. Fax: +1 813 745 7229. E-mail: [email protected]
Search for more papers by this authorMeredith C. Mason
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
Search for more papers by this authorNader N. Massarweh
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
Search for more papers by this authorAitua Salami
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Search for more papers by this authorMark A. Sultenfuss
Department of Radiology, Medical Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
Search for more papers by this authorCorresponding Author
Daniel A. Anaya
Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQUEST), Michael E. DeBakey VA Medical Center, Houston, TX, USA
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
Correspondence
Daniel A. Anaya, Section of Hepatobiliary Tumours, Depart of GI Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive - FOB 2, Tampa, FL 33612, USA. Tel.: +1 813 745 6898. Fax: +1 813 745 7229. E-mail: [email protected]
Search for more papers by this authorAbstract
Background
Transarterial chemoembolization (TACE) is the most common treatment for patients with unresectable hepatocellular carcinoma (HCC). Post-embolization syndrome (PES) is a common post-TACE complication. The goal of this study was to evaluate PES as an early predictor of the long-term outcome.
Methods
A retrospective cohort study of HCC patients treated with TACE at a tertiary referral centre was performed (2008–2014). Patients were categorized on the basis of PES, defined as fever with or without abdominal pain within 14 days of TACE. The primary outcome was overall survival (OS). Multivariate Cox regression was done to examine the association between PES and OS.
Results
Among 144 patients, 52 (36.1%) experienced PES. The median follow-up for the cohort was 11.4 months. The median and 3-year OS rates were 16 months and 18% in the PES group versus 25 months and 41% in the non-PES group (log rank, P = 0.027). After multivariate analysis, patients with PES had a significantly increased risk of death [hazard ratio 2.0 (95%CI 1.2–3.3), P = 0.011].
Conclusions
PES is a common complication after TACE and is associated with a two-fold increased risk of death. Future studies should incorporate PES as a relevant early predictor of OS and examine the biological basis of this association.
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