INCIDENCE AND PREDICTIVE ACCURACY OF POST EMBOLIZATION SYNDROME FOR SURVIVAL IN HEPATOCELLULAR CARCINOMA PATIENTS AFTER TRANSARTERIAL CHEMOEMBOLIZATION
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Keywords
Hepatocellular carcinoma, Mortality, Post embolization syndrome
Abstract
Objective: To assess the prevalence and predictive accuracy of post embolization syndrome on long-term survival outcomes in HCC patients after undergoing TACE.
Methodology: A total of 150 patients with hepatocellular carcinoma confirmed by biopsy or imaging who underwent TACE were retrospectively analysed Radiology Department of PKLI, Lahore from January 2024 to January 2025. Post embolization syndrome was diagnosed as fever that maybe accompanied by right upper quadrant abdominal pain within 2 weeks of the procedure. Patients were followed up 1, 3 and 4 months after TACE and imaging with MRI or CT was performed and laboratory parameters were recorded.
Results: ACE was successful the first time in 147 (98%) patients and 3 (2%) required additional procedure for chemoembolization.51 (34%) had post embolization syndrome. The incidence of post embolization syndrome was significantly related to mortality in the Cox regression analysis (hazard ratio: 1.9, 95 CI: 1.5-3.6, p=0.009). Multi-vascular invasion (HR: 5.0, 95% CI: 2.6-8.8, p<0.001), Child Pugh score B (HR: 2.3, 95% CI: 0.8-3.6, p=0.037) and Child Pugh score C (HR: 6.8, 95% CI: 2.9-15.4, p <0.001) were also significant predictors of mortality. Multivariable logistic analysis showed that bilobar tumor (odds ratio: 2.11, 95% CI: 0.98-4.20, p=0.052) and beads TACE (OR: 0.38, 95% CI: 0.22-1.02, p=0.050) were independently associated with post embolization syndrome.
Conclusion: Post embolization syndrome is significantly predictor of poor prognosis and mortality in HCC patients who underwent TACE.
References
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Dr. Khoala Riaz
MBBS, FCPS Clinical Fellow, Interventional Radiology, PKLI & RC Lahore
Dr. Asim Ali
MBBS, FCPS, Clinical Fellow, Interventional Radiology, PKLI & RC Lahore
Dr. Muhammad Ramzan
Consultant Radiologist, PKLI & RC Lahore
Dr. Abdullah Saeed
MRCS, FRCR(UK), CCST (UK), Consultant Interventional Radiologist, Chairman & HOD, Department of Radiology, PKLI & RC Lahore
Dr. Muhammad Usman Younas
Consultant Interventional Radiologist, PKLI & RC Lahore
