Mathieu Boulin1, Héloïse Adam2, Boris Guiu3, Ludwig Serge Aho4, Jean-Pierre Cercueil3, Cyrille Di Martino4, Philippe Fagnoni5, Anne Minello6, Jean Louis Jouve6, Patrick Hillon6, Laurent Bedenne6, Côme Lepage7. 1. Department of Pharmacy, CHU (University Hospital), 21000 Dijon, France; University of Burgundy, 21079 Dijon, France. Electronic address: mathieu.boulin@chu-dijon.fr. 2. Department of Pharmacy, CHU (University Hospital), 21000 Dijon, France. 3. Department of Radiology, CHU (University Hospital), 21000 Dijon, France; University of Burgundy, 21079 Dijon, France. 4. Department of Pharmacy, Georges Francois Leclerc Anticancer Center, 21079 Dijon Cedex, France. 5. Department of Pharmacy, CHU (University Hospital), 21000 Dijon, France; University of Burgundy, 21079 Dijon, France. 6. University of Burgundy, 21079 Dijon, France; Department of Hepatogastroenterology, CHU (University Hospital), F-21079 Dijon, France. 7. University of Burgundy, 21079 Dijon, France; Department of Hepatogastroenterology, CHU (University Hospital), F-21079 Dijon, France. Electronic address: come.lepage@u-bourgogne.fr.
Abstract
BACKGROUND: Transarterial chemoembolisation (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC), but can cause severe toxicity. AIM: 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.
BACKGROUND: Transarterial chemoembolisation (TACE) is an effective treatment for unresectable hepatocellular carcinoma (HCC), but can cause severe toxicity. AIM: 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.