Fever after transcatheter arterial chemoembolization for hepatocellular carcinoma: incidence and risk factor analysis.
OBJECTIVE
Post-treatment fever frequently occurs in hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE), but its incidence and clinical significance are unclear. The aim of this study was to identify the incidence and risk factors for fever after TACE in HCC patients.


METHODS
Forty-one consecutive HCC patients undergoing 73 sessions of TACE were included in the study. The incidence and possible risk factors associated with post-TACE fever were analyzed.


RESULTS
Forty-nine (67%) episodes of fever developed in 30 (73%) HCC patients after TACE, but none of the patients developed bacterial infection after TACE. Patients who developed fever were of younger age, had larger tumors, a higher dose of chemoembolization agents and a higher embolized volume compared with those without fever. Multivariate logistic regression disclosed that a dosage of doxorubicin plus iodized oil > 23 during chemoembolization and tumor size > 3 cm were significant predictors associated with the development ofpost-TACE fever (odds ratio: 3.749, 95% CI: 1.188-11.830, p = 0.024 and odds ratio: 3.599, 95% CI: 1.107-11.706, p = 0.033, respectively).


CONCLUSIONS
Fever after TACE is common, but infectious complications are rare. Chemoembolization dosage and tumor size are predictive of fever after transcatheter arterial chemoembolization and may be of help in the prevention and care of this distressing complication.
Li
Chung-Pin
CP
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. cpli@vghtpe.gov.tw
Chao
Yee
Y
Chen
Li-Tzong
LT
Lee
Rheun-Chuan
RC
Lee
Wei-Ping
WP
Yuan
Jeng-Nian
JN
Yen
Sang-Hue
SH
Lee
Shou-Dong
SD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D002406:Catheterization, Peripheral; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D018450:Disease Progression; D005260:Female; D005263:Femoral Artery; D005334:Fever / Q000453:epidemiology* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents