The Combination of Albumin–Bilirubin Score and Prothrombin Time Is a Useful Tool for Predicting Liver Dysfunction after Transcatheter Arterial Chemoembolization in Child–Pugh Class A Patients with Hepatocellular Carcinoma within Up-to-Seven Criteria

The Combination of Albumin–Bilirubin Score and Prothrombin Time Is a Useful Tool for Predicting Liver Dysfunction after Transcatheter Arterial Chemoembolization in Child–Pugh Class A Patients with Hepatocellular Carcinoma within Up-to-Seven Criteria

Mortality and recurrence rates of hepatocellular carcinoma (HCC) are high. Recent studies show that for patients with HCC beyond up-to-seven criteria, treatment with molecular-targeted agents (MTAs) is recommended because the treatment efficiency of transcatheter arterial chemoembolization (TACE) is...

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Main Authors: Hiroaki Takaya, Tadashi Namisaki, Soichi Takeda, Kosuke Kaji, Hiroyuki Ogawa, Koji Ishida, Yuki Tsuji, Hirotetsu Takagi, Takahiro Ozutsumi, Yukihisa Fujinaga, Masanori Furukawa, Koh Kitagawa, Norihisa Nishimura, Yasuhiko Sawada, Naotaka Shimozato, Hideto Kawaratani, Kei Moriya, Takemi Akahane, Akira Mitoro, Hitoshi Yoshiji
Format: article
Language:EN
Published: MDPI AG 2021
Subjects:
albumin
bilirubin
therapeutic chemoembolization
hepatocellular carcinoma
liver dysfunction
Medicine
R
Online Access:https://doaj.org/article/b7581f6e13ef4e4f80e61dab9184124c
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Summary:Mortality and recurrence rates of hepatocellular carcinoma (HCC) are high. Recent studies show that for patients with HCC beyond up-to-seven criteria, treatment with molecular-targeted agents (MTAs) is recommended because the treatment efficiency of transcatheter arterial chemoembolization (TACE) is poor; further, TACE increases decline in liver function. However, the relationship between TACE and liver function decline in patients with HCC within up-to-seven criteria has not been clarified. Hence, we aimed to investigate this relationship. This retrospective observational study included 189 HCC tumors within up-to-seven criteria in 114 Child–Pugh class A patients. Twenty-four (12.7%) tumors were changed from Child–Pugh class A to B after TACE, and 116 (61.4%) tumors exhibited recurrence within 6 months after TACE. Prothrombin time (PT) and albumin–bilirubin (ALBI) score before TACE were significantly associated with liver dysfunction from Child–Pugh class A to B. The combination of PT and ALBI score before TACE had high predictive ability for liver dysfunction from Child–Pugh class A to B after TACE (specificity = 100%, sensitivity = 91.7%). The combined use of pre-TACE PT and ALBI score has a high predictive ability for liver dysfunction after TACE for Child–Pugh class A patients with HCC within up-to-seven criteria.

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