The development of early ascites is associated with shorter overall survival in patients with hepatocellular carcinoma treated with drug-eluting embolic chemoembolization

BMC Gastroenterology

María Pipa-Muñiz¹  Manuel Rodríguez²  Maria-Luisa González-Diéguez²  Carmen Álvarez-Navascués²  Valle Cadahía²  María Varela²  Susana Sanmartino³  José-Eduardo Rodríguez³  Florentino Vega³  Alicia Mesa³  Serafin-Marcos Costilla-García³ 

[1]Division of Gastroenterology and Hepatology, Hospital de Cabueñes

[2]Liver Unit, Hospital Universitario Central de Asturias

[3]Radiology Department, Hospital Universitario Central de Asturias

关键词: Hepatocellular carcinoma;    DEB-TACE;    Ascites;    Response;    Survival;   

DOI  :  10.1186/s12876-020-01307-x

来源: DOAJ

【 摘 要 】

Abstract Background A single-centre cohort study was performed to identify the independent factors associated with the overall survival (OS) of hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization with drug-eluting beads (DEB-TACE). Methods A total of 216 HCC patients who underwent DEB-TACE from October 2008 to October 2015 at a tertiary hospital were consecutively recruited. The analysis of prognostic factors associated with overall survival after DEB-TACE, stressing the role of post-TACE events, was performed. Results The objective response (OR) rate (Modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria) to the first DEB-TACE (DEB-TACE-1) was 70.3%; the median OS from DEB-TACE-1 was 27 months (95% confidence interval (CI), 24–30). In the multivariate analysis, tumor size, AFP < 100 ng/mL and serum alkaline phosphatase were independent factors for survival following DEB-TACE-1. The most important clinical event associated with poor survival was the development of early ascites after DEB-TACE-1 (median OS, 17 months), which was closely related to the history of ascites, albumin and hemoglobin but not to tumour load or to response to therapy. Conclusions Early ascites post-DEB-TACE is associated with the survival of patients despite adequate liver function and the use of a supra-selective technical approach. History of ascites, albumin and hemoglobin are major determinants of the development of early ascites post-DEB-TACE.

【 授权许可】

Unknown