REGULAR CONTENT
Final ID
485
Type
Original Scientific Research-Oral or Pos
Authors
M Patel1, A Woerner1, M Borge1, H Fouad1, P Amin1, S Cotler1, C Molvar1
Institutions
1Loyola University Medical Center, Maywood, IL
Purpose
To evaluate the outcomes of patients with elevated bilirubin levels undergoing locoregional therapy with conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC).
Materials & Methods
A single institution retrospective review of patients with HCC and total bilirubin (T-bili) levels ≥3.0 mg/dL for which cTACE was performed, from 1/2013 to 7/2016. cTACE was performed with Lipiodol and 50mg Doxorubicin/10mg Mitomycin-C. Pre- and post-procedural analysis at 30 and 90 days included total bilirubin levels, Child Pugh Score, albumin-bilirubin (ALBI) score, rate of adverse outcomes (as described by NCI Common Terminology Criteria for Adverse Events, Hepatobiliary toxicity), and mortality, along with ongoing follow up imaging based on RECIST criteria to evaluate tumor response.
Results
At our institution, 19 patients with an elevated T-bili ≥ 3.0 mg/dL (mean of 3.64 mg/dL ±0.51) underwent 20 cTACE procedures from 1/2013 to 7/2016. Two patients received anticipated liver transplants within 90 days of cTACE, for which limited analysis was performed. Post-procedural results demonstrated transient elevation of T-bili at 30 days (mean 4.47 mg/dL ±2.32) with return to baseline by 90 days (mean 3.59 mg/dL ±1.89). 30 and 90 day follow-up of adverse events demonstrated 3 cases of transient transaminitis, 7 cases of new or worsening ascites and lower extremity edema, and 4 cases of encephalopathy. 5 cases demonstrated transient progression of hepatic dysfunction at 30 days with deterioration of Child Pugh score from B to C, 3 of which returned to class B by 90 days. Pre-procedural, 30, and 90 day ALBI scores were -1.02 (±0.37), -0.89 (±0.28), and -0.89 (±0.51), respectively, with overall survival rate at 90 days of 100%.
Conclusions
cTACE for patients with HCC and T-bili levels ≥3.0 mg/dL can be performed safely with relatively transient alterations in hepatic function and low rate of adverse post-procedural outcomes.
Final ID
485
Type
Original Scientific Research-Oral or Pos
Authors
M Patel1, A Woerner1, M Borge1, H Fouad1, P Amin1, S Cotler1, C Molvar1
Institutions
1Loyola University Medical Center, Maywood, IL
Purpose
To evaluate the outcomes of patients with elevated bilirubin levels undergoing locoregional therapy with conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC).
Materials & Methods
A single institution retrospective review of patients with HCC and total bilirubin (T-bili) levels ≥3.0 mg/dL for which cTACE was performed, from 1/2013 to 7/2016. cTACE was performed with Lipiodol and 50mg Doxorubicin/10mg Mitomycin-C. Pre- and post-procedural analysis at 30 and 90 days included total bilirubin levels, Child Pugh Score, albumin-bilirubin (ALBI) score, rate of adverse outcomes (as described by NCI Common Terminology Criteria for Adverse Events, Hepatobiliary toxicity), and mortality, along with ongoing follow up imaging based on RECIST criteria to evaluate tumor response.
Results
At our institution, 19 patients with an elevated T-bili ≥ 3.0 mg/dL (mean of 3.64 mg/dL ±0.51) underwent 20 cTACE procedures from 1/2013 to 7/2016. Two patients received anticipated liver transplants within 90 days of cTACE, for which limited analysis was performed. Post-procedural results demonstrated transient elevation of T-bili at 30 days (mean 4.47 mg/dL ±2.32) with return to baseline by 90 days (mean 3.59 mg/dL ±1.89). 30 and 90 day follow-up of adverse events demonstrated 3 cases of transient transaminitis, 7 cases of new or worsening ascites and lower extremity edema, and 4 cases of encephalopathy. 5 cases demonstrated transient progression of hepatic dysfunction at 30 days with deterioration of Child Pugh score from B to C, 3 of which returned to class B by 90 days. Pre-procedural, 30, and 90 day ALBI scores were -1.02 (±0.37), -0.89 (±0.28), and -0.89 (±0.51), respectively, with overall survival rate at 90 days of 100%.
Conclusions
cTACE for patients with HCC and T-bili levels ≥3.0 mg/dL can be performed safely with relatively transient alterations in hepatic function and low rate of adverse post-procedural outcomes.