Child–Pugh grade deterioration stratified by the etiology after transcatheter arterial chemoembolization as initial treatment for hepatocellular carcinoma

• Published in: Scientific reports Vol. 14; no. 1; p. 3707
• Main Authors: Yoshitomi, Kengo, Hayashi, Tsuguru, Oe, Shinji, Shibata, Michihiko, Honma, Yuichi, Harada, Masaru, Kooka, Yohei
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 14.02.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4020; 692/4020/4021/1607/1604; 692/4020/4021/1607/1610; Carcinoma, Hepatocellular - pathology; Chemoembolization; Chemoembolization, Therapeutic - adverse effects; Chemoembolization, Therapeutic - methods; Child Pugh grade; Etiology; Hepatitis; Hepatitis B; Hepatitis C; Hepatitis C - complications; Hepatitis C - therapy; Hepatocellular carcinoma; Humanities and Social Sciences; Humans; Liver; Liver cancer; Liver diseases; Liver function; Liver Neoplasms - pathology; multidisciplinary; Regression analysis; Retrospective Studies; Science; Science (multidisciplinary); Liver function; Child Pugh grade; Hepatocellular carcinoma
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-53709-6

Transcatheter arterial chemoembolization (TACE) is a standard treatment for intermediate-stage hepatocellular carcinoma (HCC). However, TACE can cause deterioration of liver functions. We aimed to identify the factors that influence deterioration of liver function after TACE. We retrospectively analyzed 262 patients who underwent TACE as initial treatment for HCC with Child–Pugh grade A. We divided them into three groups stratified by the etiology of underlying liver disease. Patients were classified into hepatitis B virus (HBV) group, hepatitis C virus (HCV) group, and non-HBV / non-HCV (NBNC) group. Liver functions at one month after TACE and time to Child–Pugh grade B or C were compared between the three groups. The HBV, HCV and NBNC groups contained 23, 123 and 116 patients, respectively. The decline in albumin level after TACE was significantly higher in NBNC group than other groups (p = 0.02). NBNC group showed a shorter time to Child–Pugh grade deterioration compared with HBV group and HCV group (p < 0.001). Multivariate Cox regression analysis showed that NBNC group was a significant factor for Child–Pugh grade deterioration (Hazard ratio 3.74, 95% confidence interval 1.89–7.40, p < 0.001). These results revealed that liver functions worsened most remarkably in NBNC group after TACE.