Transcatheter Arterial Chemoembolization in Patient with Hepatocellular Carcinoma in Srinagarind Hospital; Complications and Results

Abstract

Background: Transcatheter arterial chemoembolization (TACE) is known to be one of the best palliative treatment for unresectable HCC. However, its severe complications make its use controversial.

Purpose: To evaluate the complications and results of TACE in our treated cases.

Materials and Methods: Forty-seven patients underwent 88 TACE sessions during January 1, 2003 to December 31, 2004 at Srinagarind Hospital. Their clinical records, complications of TACE. tumor response. and survival outcomes, were reviewed retrospectively.

Results: Forty-seven patients (40 males [85%], 7 females [15%], mean age 51 years, underwent 88 chemoembolizations. Forty-two patients (89%) had documented cirrhosis, 28 (59%) had hepatitis B and 39 (83%) were chronic alcohol drinkers. Thirty-eight patients (81%). and 9 patients (19%) were categorized in Child’s A and B classes, respectively. The common complications of TACE included fever (83%), abdominal pain (37%) and transient nausea/emesis (20%). Two patients with right portal vein (RPV) thrombosis developed acute liver failure within few days after TACE. One of them had sepsis syndrome. Partial and minimal tumor response was observed (33%). Overall survival rate was 61%, 48%. 27%, and 9% of patients at up to 6 months. 1, 2, and 3 years, respectively. The mean survival time was 13.1 months.

Conclusion: Most complications in our study can be corrected except for serious complication (acute liver failure) in 2 cases with RPV invasion. Very careful pretreatment planning should help reduce the problem. The response of treatment was found in 33%. The 2- and 3-years survival rate was 27% and 9%, respectively. We believe that we can do better in the future if the patients come to us in earlier stage.