Impact of Transarterial Chemoembolization or Hepatic Artery Infusion Chemotherapy on Liver Function after Hepatocellular Carcinoma Resection: An Observational Study

Digestion. 2023;104(4):291-298. doi: 10.1159/000528750. Epub 2023 Feb 6.

Abstract

Introduction: Liver surgery leads to a high degree of heterogeneity in the prognosis of hepatocellular carcinoma (HCC) patients. However, most previous studies focused on the postoperative therapeutic effects of other treatments, with relatively few studies on the impacts on liver function. This study investigated the impact of transarterial chemoembolization (TACE) and hepatic artery infusion chemotherapy (HAIC) on liver function after HCC resection from various angles.

Methods: 138 HCC patients were enrolled, including 27 patients who received TACE and 80 patients who received HAIC. Besides routine treatment such as liver protection and antiviral therapy, 31 patients received no other treatment. The different groups were compared with various biological parameters with four types of scoring methods.

Results: In the short term after TACE, the mean (±SD) alanine transaminase and aspartate transaminase values increased by 79.22 ± 117.43 U/L and 66.33 ± 94.54 U/L, respectively (p < 0.01). The mean (±SD) total bilirubin (TBIL) values increased by 4.02 ± 6.08 μmol/L (p < 0.01). The mean (±SD) albumin (ALB) values decreased by 3.54 ± 2.93 g/L (p < 0.001). The mean (±SD) albumin bilirubin (ALBI) scores increased by 0.39 ± 0.22 (p < 0.001). In the short term after HAIC, the mean (±SD) TBIL values increased by 2.11 ± 5.57 μmol/L (p < 0.01). The mean (±SD) ALB values decreased by 2.52 ± 3.26 g/L (p < 0.001), and the mean (±SD) ALBI scores increased by 0.21 ± 0.42 (p < 0.001). In both treatment groups, the long-term liver function was not significantly different from that before treatment and also from that of the untreated group (p > 0.05).

Conclusion: TACE after HCC resection has a significant impact on short-term liver function, whereas HAIC has a relatively small impact, but neither has a major impact on long-term liver function.

Keywords: Hepatic artery infusion chemotherapy; Hepatocellular carcinoma; Liver function; Postoperation; Transarterial chemoembolization.

Publication types

  • Observational Study

MeSH terms

  • Albumins / therapeutic use
  • Bilirubin
  • Carcinoma, Hepatocellular* / surgery
  • Chemoembolization, Therapeutic* / methods
  • Hepatic Artery / pathology
  • Humans
  • Liver Neoplasms* / surgery
  • Treatment Outcome

Substances

  • Albumins
  • Bilirubin