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The purpose of this study was to evaluate the predictors of deterioration of the Child-Pugh classification 1 month after transcatheter arterial chemo-embolization (TACE) in patients with treatment-naive hepatocellular carcinoma (HCC).

Between 2010 and 2020, consecutive patients who underwent conventional TACE using epirubicin as the initial treatment were enrolled. Patients with Barcelona Clinic Liver Cancer stage-0, A or B and Child-Pugh class A were included. The Child-Pugh score was evaluated before treatment and 1 month after TACE. The following variables were analyzed by univariate and multivariate analyses as predictors of deterioration of the Child-Pugh class from A to B: age, sex, etiology, serum albumin, bilirubin, prothrombin time (PT), encephalopathy, ascites, largest tumor diameter, tumor number, tumor location, α-fetoprotein, protein induced by vitamin K absence or antagonist-II, epirubicin dosage, ethiodized oil dosage, and number of treated liver segments.

A total of 152 patients were retrospectively enrolled. The deterioration rate of the Child-Pugh class from A to B was 8.6%. Multivariable analysis showed that serum albumin ≤ 3.8 g/dL, PT ≤ 80%, and largest tumor diameter ≥ 3.8 cm were predictors of deterioration of the Child-Pugh class. The deterioration rate to Child-Pugh class B was 0% in patients with up to one of these factors, 14.3% in those with two factors, and 70% in those with three factors.

A combination of serum albumin ≤ 3.8 g/dL, PT ≤ 80%, and largest tumor diameter ≥ 3.8 cm can predict the immediate deterioration of the Child-Pugh classification from A to B following TACE.

Paper information

Journal: Cancer Medicine
Title: Predictors of immediate deterioration of the Child-Pugh classification from A to B after transcatheter arterial chemo-embolization for treatment-naive hepatocellular carcinoma
DOI: 10.1002/cam4.70367
Authors: Kazuo Asano, Ken Kageyama, Akira Yamamoto, Atsushi Jogo, Mariko Nakano, Kazuki Murai, Yoshimi Yukawa-Muto, Naoshi Odagiri, Kohei Kotani, Ritsuzo Kozuka, Etsushi Kawamura, Hideki Fujii, Sawako Uchida-Kobayashi, Masaru Enomoto, Norifumi Kawada, Yukio Miki
Published: 2 November 2024
URL: https://doi.org/10.1002/cam4.70367

Contact

Kazuo Asano
Graduate School of Medicine
Email: k.asano[at]omu.ac.jp

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