Factors influencing postembolization syndrome in patients with hepatocellular carcinoma undergoing first transcatheter arterial chemoembolization

J Cancer Res Ther. 2021 Jul;17(3):777-783. doi: 10.4103/jcrt.jcrt_132_21.

Abstract

Context: Postembolization syndrome (PES) is the most common complication in patients with hepatocellular carcinoma (HCC) who had undergone transcatheter arterial chemoembolization (TACE). PES was defined as fever, nausea and/or vomiting, and abdominal pain and these symptoms develop within 1-3 days after TACE. However, few studies have explored the factors influencing PES in patients with TACE for the first time.

Aims: We explored the factors influencing PES in patients with HCC undergoing TACE for the first time.

Settings and design: The present study was a hospital-based study conducted in the tertiary care hospital of Guangzhou with a retrospective study design.

Subjects and methods: In this single-center retrospective study, a total of 242 patients with HCC were included in the first TACE program between November 1, 2018 and November 31, 2019.

Statistical analysis used: T-test and Chi-square test revealed the factors affecting the occurrence of PES. Correlation analysis (Spearman) explored the relationship between these factors and PES. Binary logistics analyzed the predictive factors of PES.

Results: The probability of PES in patients with HCC undergoing TACE for the first time was 55.45%. Types of embolic agents (r = 0.296), types of microspheres (r = 0.510), number of microspheres (r = 0.130), maximum diameter of microspheres used (r = 0.429), type of drug (r = 0.406), and drug loading (r = 0.433) were positively correlated with PES (P < 0.05). Serum albumin was negatively correlated with PES (P = 0.008, r = -0.170). Binary logistic regression analysis revealed that drug loading microspheres (odds ratio [OR] = 0.075, 95% confidence interval [CI] = 0.031-0.180) and serum albumin (OR = 0.182, 95% CI = 0.068-0.487) were the protective factors influencing PES, while drug loading was the risk factor of PES (OR = 1.407, 95% CI = 1.144-1.173).

Conclusions: Drug loading microspheres, serum albumin, and drug loading were the predictors of PES after the first TACE.

Keywords: Hepatocellular carcinoma; postembolization syndrome; transcatheter arterial chemoembolization.

MeSH terms

  • Abdominal Pain / epidemiology
  • Abdominal Pain / etiology
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / adverse effects*
  • Chemoembolization, Therapeutic / methods
  • Female
  • Femoral Artery / surgery
  • Fever / epidemiology
  • Fever / etiology
  • Humans
  • Liver / blood supply
  • Liver / pathology
  • Liver Neoplasms / blood
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Male
  • Microspheres
  • Middle Aged
  • Nausea / epidemiology
  • Nausea / etiology
  • Particle Size
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin, Human / analysis
  • Syndrome
  • Vomiting / epidemiology
  • Vomiting / etiology
  • Young Adult

Substances

  • Antineoplastic Agents
  • Serum Albumin, Human