The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma

Our aim was to investigate how transcatheter arterial chemoembolization (TACE) combined with percutaneous radiofrequency ablation (RFA) affected liver parenchymal function in patients with hepatocellular carcinoma (HCC), and to evaluate the significant risk factors for post-procedural deterioration...

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Main Authors: Jia-Xin Li, Hong Wu, Ji-Wei Huang, Yong Zeng
Format: Article
Language:English
Published: Elsevier 2012-09-01
Series:Journal of the Formosan Medical Association
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0929664612000770
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spelling doaj-5edeab2e6851409a8d90d185275732d12020-11-24T22:54:17ZengElsevierJournal of the Formosan Medical Association0929-66462012-09-01111951051510.1016/j.jfma.2011.05.016The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinomaJia-Xin LiHong WuJi-Wei HuangYong ZengOur aim was to investigate how transcatheter arterial chemoembolization (TACE) combined with percutaneous radiofrequency ablation (RFA) affected liver parenchymal function in patients with hepatocellular carcinoma (HCC), and to evaluate the significant risk factors for post-procedural deterioration of liver function. Methods: Changes in liver laboratory tests and development of complications were monitored in 53 patients with unresectable hepatocellular carcinoma from January 2007 to January 2009. Cox proportional hazard regression model was performed to evaluate risk factors for deterioration of liver function after the procedure. Results: Plasma total bilirubin (TB) increased from pre-procedural 22.1 ± 12.4 μmol/L to 34.1 ± 21.8 μmol/L on post-procedural day three (P = 0.017). Alanine aminotransferase (ALT) also increased greatly from 65 ± 58 IU/L to 285 ± 182 IU/L post-procedurally (P = 0.006). Albumin (ALB) dropped from 42.5 ± 4.5 g/L to 34.6 ± 5.4 g/L (P = 0.019) and the Child–Pugh score increased from 5.2 ± 1.3 to 7.1 ± 1.5 three days after treatment (P = 0.021). Most of these parameters returned to normal range within 3–4 weeks. Thirty-three out of 53 patients developed complications in our study. Cox proportional hazards regression univariate analysis demonstrated that a Child–Pugh score ≥9 points and age ≥60 years were risk factors for deterioration of liver function after the procedure. Furthermore, a Child–Pugh score ≥9 points was found to be the only risk factor for post-procedural deterioration of liver function identified by stepwise multivariate analysis. Conclusion: Liver function parameters such as plasma total bilirubin, ALT, serum ALB and Child–Pugh score could be transiently deteriorated by TACE combined with RFA in patients with Child–Pugh grades B or C. Therefore, patients with a Child–Pugh score ≥9 points were not appropriate candidates for TACE combined with RFA.http://www.sciencedirect.com/science/article/pii/S0929664612000770transcatheter arterial chemoembolizationradiofrequency ablationliver function parametershepatocellular carcinoma
collection DOAJ
language English
format Article
sources DOAJ
author Jia-Xin Li
Hong Wu
Ji-Wei Huang
Yong Zeng
spellingShingle Jia-Xin Li
Hong Wu
Ji-Wei Huang
Yong Zeng
The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma
Journal of the Formosan Medical Association
transcatheter arterial chemoembolization
radiofrequency ablation
liver function parameters
hepatocellular carcinoma
author_facet Jia-Xin Li
Hong Wu
Ji-Wei Huang
Yong Zeng
author_sort Jia-Xin Li
title The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma
title_short The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma
title_full The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma
title_fullStr The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma
title_full_unstemmed The influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma
title_sort influence on liver function after transcatheter arterial chemoembolization combined with percutaneous radiofrequency ablation in patients with hepatocellular carcinoma
publisher Elsevier
series Journal of the Formosan Medical Association
issn 0929-6646
publishDate 2012-09-01
description Our aim was to investigate how transcatheter arterial chemoembolization (TACE) combined with percutaneous radiofrequency ablation (RFA) affected liver parenchymal function in patients with hepatocellular carcinoma (HCC), and to evaluate the significant risk factors for post-procedural deterioration of liver function. Methods: Changes in liver laboratory tests and development of complications were monitored in 53 patients with unresectable hepatocellular carcinoma from January 2007 to January 2009. Cox proportional hazard regression model was performed to evaluate risk factors for deterioration of liver function after the procedure. Results: Plasma total bilirubin (TB) increased from pre-procedural 22.1 ± 12.4 μmol/L to 34.1 ± 21.8 μmol/L on post-procedural day three (P = 0.017). Alanine aminotransferase (ALT) also increased greatly from 65 ± 58 IU/L to 285 ± 182 IU/L post-procedurally (P = 0.006). Albumin (ALB) dropped from 42.5 ± 4.5 g/L to 34.6 ± 5.4 g/L (P = 0.019) and the Child–Pugh score increased from 5.2 ± 1.3 to 7.1 ± 1.5 three days after treatment (P = 0.021). Most of these parameters returned to normal range within 3–4 weeks. Thirty-three out of 53 patients developed complications in our study. Cox proportional hazards regression univariate analysis demonstrated that a Child–Pugh score ≥9 points and age ≥60 years were risk factors for deterioration of liver function after the procedure. Furthermore, a Child–Pugh score ≥9 points was found to be the only risk factor for post-procedural deterioration of liver function identified by stepwise multivariate analysis. Conclusion: Liver function parameters such as plasma total bilirubin, ALT, serum ALB and Child–Pugh score could be transiently deteriorated by TACE combined with RFA in patients with Child–Pugh grades B or C. Therefore, patients with a Child–Pugh score ≥9 points were not appropriate candidates for TACE combined with RFA.
topic transcatheter arterial chemoembolization
radiofrequency ablation
liver function parameters
hepatocellular carcinoma
url http://www.sciencedirect.com/science/article/pii/S0929664612000770
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