title: Complications of image-guided transcatheter hepatic chemoembolization of primary and secondary tumours of the liver.
abstract: BACKGROUND
  Image-guided transcatheter hepatic chemoembolization (TACE) is accepted worldwide as an effective treatment for patients with unresectable hepatocellular carcinoma (HCC) and for adequate preservation of liver function. Although considered relatively safe, TACE has been associated with several complications. The aim of this study was to determine the prevalence of the complications associated with TACE therapy and to correlate it with certain risk factors, either well-known or not yet evaluated.
  
  
  METHODS
  A total of 330 chemoembolization procedures performed in 170 patients (117 males and 53 females) over a period of 64 months were retrospectively analysed. Among the patients, 123 had hepatocellular carcinoma, 10 had intrahepatic cholangiocarcinoma and 37 had hepatic metastases. The variables considered were: tumour histotype, bilioenteric anastomosis, previous or combined treatment with radiofrequency thermal ablation, antibiotic prophylaxis, chemotherapeutic agents, use of new drug-eluting microspheres, comorbidities such as diabetes, patient age and the presence of vascular anatomical variations.
  
  
  RESULTS
  A total of 30 complications occurred in 27 procedures. The total complication rate per procedure was 9.1% and approximately 75% of patients had postembolization syndrome. The difference in the prevalence of complications was statistically significant in the group of diabetic patients (13.3%) compared to the remaining patients (6.3%) (p = 0.002) and in patients with biliary stents (25%) compared to those without stents (7.75%) (p = 0.027).
  
  
  CONCLUSIONS
  These data show that diabetes mellitus and the presence of bilioenteric anastomosis are risk factors for developing complications after TACE. The use of new drug-eluting microspheres did not increase the risk of complications.
authors.affiliation: Department of Oncology,IRCCS Fondazione S. Maugeri, Istituto Scientifico di Pavia, Italy. guido.poggi@fsm.it
authors.forename: Guido
authors.initials: G
authors.lastname: Poggi
authors.forename: Emma
authors.initials: E
authors.lastname: Pozzi
authors.forename: Alberto
authors.initials: A
authors.lastname: Riccardi
authors.forename: Stefano
authors.initials: S
authors.lastname: Tonini
authors.forename: Benedetta
authors.initials: B
authors.lastname: Montagna
authors.forename: Pietro
authors.initials: P
authors.lastname: Quaretti
authors.forename: Barbara
authors.initials: B
authors.lastname: Tagliaferri
authors.forename: Federico
authors.initials: F
authors.lastname: Sottotetti
authors.forename: Paola
authors.initials: P
authors.lastname: Baiardi
authors.forename: Chiara
authors.initials: C
authors.lastname: Pagella
authors.forename: Claudio
authors.initials: C
authors.lastname: Minoia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bernardo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000379:methods; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies