Dataset Information

Portal hypertension increases the risk of hepatic decompensation after 90Yttrium radioembolization in patients with hepatocellular carcinoma: a cohort study.

ABSTRACT:

Background

Transarterial radioembolization (TARE) is increasingly used in patients with hepatocellular carcinoma (HCC). This treatment can induce or impair portal hypertension, leading to hepatic decompensation. TARE also promotes changes in liver and spleen volumes that may modify therapeutic decisions and outcomes after therapy.

Objectives

We aimed to investigate the impact of TARE on the incidence of decompensation events and its predictive factors.

Design

In all, 63 consecutive patients treated with TARE between February 2012 and December 2018 were retrospectively included.

Methods

We assessed clinical (including Barcelona Clinic Liver Cancer stage, portal hypertension assessment, and liver decompensation), laboratory parameters, and liver and spleen volumes before and 6 and 12 weeks after treatment. A multivariate analysis was performed.

Results

In total, 18 out of 63 (28.6%) patients had liver decompensation (ascites, variceal bleeding, jaundice, or encephalopathy) within the first 3 months after therapy, not associated with tumor progression. Clinically significant portal hypertension (CSPH) and bilobar treatment independently predicted the development of liver decompensation after TARE. A significant volume increase in the non-treated hemi-liver was observed only in patients with unilobar treatment (median volume increase of 20.2% in patients with right lobe TARE; p = 0.007), especially in those without CSPH. Spleen volume also increased after TARE (median volume increase of 16.1%; p = 0.0001) and was associated with worsening liver function scores and decreased platelet count.

Conclusion

Bilobar TARE and CSPH may be associated with an increased risk of liver decompensation in patients with intermediate or advanced HCC. A careful assessment considering these variables before therapy may optimize candidate selection and improve treatment planning.

SUBMITTER: Carrion L

PROVIDER: S-EPMC10619355 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Portal hypertension increases the risk of hepatic decompensation after 90Yttrium radioembolization in patients with hepatocellular carcinoma: a cohort study.

Carrión Laura L Clemente-Sánchez Ana A Márquez-Pérez Laura L Orcajo-Rincón Javier J Rotger Amanda A Ramón-Botella Enrique E González-Leyte Manuel M Echenagusía-Boyra Miguel M Luis Colón Arturo A Reguera-Berenguer Laura L Bañares Rafael R Rincón Diego D Matilla-Peña Ana A

Therapeutic advances in gastroenterology 20231031

<h4>Background</h4>Transarterial radioembolization (TARE) is increasingly used in patients with hepatocellular carcinoma (HCC). This treatment can induce or impair portal hypertension, leading to hepatic decompensation. TARE also promotes changes in liver and spleen volumes that may modify therapeutic decisions and outcomes after therapy.<h4>Objectives</h4>We aimed to investigate the impact of TARE on the incidence of decompensation events and its predictive factors.<h4>Design</h4>In all, 63 con ...[more]

PMID: 37920686

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Dataset Information

Portal hypertension increases the risk of hepatic decompensation after 90Yttrium radioembolization in patients with hepatocellular carcinoma: a cohort study.

Background

Objectives

Design

Methods

Results

Conclusion

Publications

Portal hypertension increases the risk of hepatic decompensation after 90Yttrium radioembolization in patients with hepatocellular carcinoma: a cohort study.

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