Predictive factors of transarterial chemoembolisation toxicity in unresectable hepatocellular carcinoma.
BACKGROUND
Transarterial chemoembolisation (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC), but can cause severe toxicity.


OBJECTIVE
To identify predictive factors of severe TACE-related toxicity in patients with unresectable HCC.


METHODS
All HCC patients who underwent TACE at the Dijon University Hospital between 2008 and 2011 were included in this retrospective study. Severe TACE-related toxicity was defined as the occurrence of any adverse event grade ≥ 4, or any adverse event that caused a prolongation of hospitalisation of >8 days, or any additional hospitalisation within 1 month after TACE. Factors predicting toxicity were identified using a logistic regression model. The robustness of the final model was confirmed using bootstrapping (500 replications).


RESULTS
124 patients were included, median age was 67 years and 90% were male; 22 patients (18%) experienced severe TACE-related toxicity. Factors that independently predicted severe TACE-related toxicity in multivariate analysis were total tumour size (OR, 1.15 cm(-1); 95%CI, 1.04-1.26; p=0.01), and high serum AST levels (OR, 1.10 per 10 IU/l; 95%CI, 1.01-1.21; p=0.04). The results were confirmed by bootstrapping.


CONCLUSIONS
Total tumour size and high serum AST levels were predictive factors of severe TACE-related toxicity in this hospital-based series of patients with unresectable HCC.
Department of Pharmacy, CHU (University Hospital), 21000 Dijon, France; University of Burgundy, 21079 Dijon, France. Electronic address: mathieu.boulin@chu-dijon.fr.
Mathieu
M
Boulin
Department of Pharmacy, CHU (University Hospital), 21000 Dijon, France.
Héloïse
H
Adam
Department of Radiology, CHU (University Hospital), 21000 Dijon, France; University of Burgundy, 21079 Dijon, France.
Boris
B
Guiu
Department of Pharmacy, Georges Francois Leclerc Anticancer Center, 21079 Dijon Cedex, France.
Ludwig Serge
LS
Aho
Department of Radiology, CHU (University Hospital), 21000 Dijon, France; University of Burgundy, 21079 Dijon, France.
Jean-Pierre
JP
Cercueil
Department of Pharmacy, Georges Francois Leclerc Anticancer Center, 21079 Dijon Cedex, France.
Cyrille
C
Di Martino
Department of Pharmacy, CHU (University Hospital), 21000 Dijon, France; University of Burgundy, 21079 Dijon, France.
Philippe
P
Fagnoni
University of Burgundy, 21079 Dijon, France; Department of Hepatogastroenterology, CHU (University Hospital), F-21079 Dijon, France.
Anne
A
Minello
University of Burgundy, 21079 Dijon, France; Department of Hepatogastroenterology, CHU (University Hospital), F-21079 Dijon, France.
Jean Louis
JL
Jouve
University of Burgundy, 21079 Dijon, France; Department of Hepatogastroenterology, CHU (University Hospital), F-21079 Dijon, France.
Patrick
P
Hillon
University of Burgundy, 21079 Dijon, France; Department of Hepatogastroenterology, CHU (University Hospital), F-21079 Dijon, France.
Laurent
L
Bedenne
University of Burgundy, 21079 Dijon, France; Department of Hepatogastroenterology, CHU (University Hospital), F-21079 Dijon, France. Electronic address: come.lepage@u-bourgogne.fr.
Côme
C
Lepage
D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001219:Aspartate Aminotransferases / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology / Q000628:therapy*; D056486:Chemical and Drug Induced Liver Injury; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects* / Q000401:mortality; D015331:Cohort Studies; D004317:Doxorubicin / Q000009:adverse effects; D005260:Female; D006501:Hepatic Encephalopathy / Q000209:etiology*; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D015255:Idarubicin / Q000009:adverse effects; D008103:Liver Cirrhosis / Q000150:complications; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D017114:Liver Failure, Acute / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D047368:Tumor Burden
D004317:Doxorubicin; D001219:Aspartate Aminotransferases; D015255:Idarubicin
Hepatocellular carcinoma; Toxicity; Transarterial chemoembolisation