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Prediction of Postembolization Syndrome After Transarterial Chemoembolization of Hepatocellular Carcinoma and Its Impact on Prognosis
Natascha Röhlen
Fabian Manfred Stöhr
Lukas Müller
Hendrik Luxenburger
Simon J. Gairing
Marlene Elisabeth Reincke
Michael Schultheiß
Floriona Berisha
Arndt Weinmann
Friedrich Foerster
Jens Uwe Marquardt
Robert Thimme
Peter R. Galle
Dominik Bettinger
Roman Trutz Klöckner
出版
Universität
, 2023
URL
http://books.google.com.hk/books?id=O3Ne0AEACAAJ&hl=&source=gbs_api
註釋
Abstract: Background:
Postembolization syndrome (PES) represents the most frequent complication after transarterial chemoembolization (TACE) in patients with HCC. Given the vague definition as a symptom complex comprising abdominal pain, fever, and nausea, PES is diagnosed in heterogeneous patient cohorts with symptoms ranging from mild pain to severe deterioration of their general condition. This study aimed to evaluate predictive factors and the prognostic impact of PES with regard to different severity grades.
Methods:
A total of 954 patients treated with TACE for HCC at the University Medical Centres Mainz and Freiburg were included in this study. PES disease severity was graded as mild, moderate, or severe according to a predefined combination of symptoms. Logistic regression models were used to identify independent predictors of PES. The prognostic impact of PES was evaluated by competing risk analyses considering liver transplantation as a competing risk.
Results:
PES occurred in 616 patients (64.5%), but only 56 patients (5.9%) had severe PES, defined as moderate to severe abdominal pain requiring opioids in combination with fever and nausea. The largest tumor diameter was the strongest independent predictor of PES (OR = 1.21, 95% CI = 1.13-1.28), and severe PES (OR = 1.23, 95% CI = 1.14-1.33, p 0.0001). Presence of liver cirrhosis was protective against PES (OR = 0.48, 95% CI = 0.27-0.84, p = 0.01). Furthermore, PES was independently associated with an impaired disease control rate (OR = 0.33, 95% CI = 0.16-0.69, p = 0.003) and severe PES with poor overall survival (subdistribution HR = 1.53, 95% CI = 0.99-2.36, p = 0.04).brbrConclusions: