Mahmoud Elkadeem is the Lecturer of Tropical Medicine & Infectious Diseases at Faculty of Medicine, Tanta University, Egypt since 2017. He has completed his master and PhD in Tropical Medicine & Hygiene in 2012 and 2017 respectively. He has experience in the field of gastroenterology and hepatology.
Abstract
Background: Hepatocellular carcioma is one of the leading causes of cancer deaths worldwide. Transarterial chemoembolization (TACE) is a standard therapy for intermediate stage of liver cancer. However, it may have a risk of mortality and morbidity. Many factors other than radiological response determine TACE outcomes.
Aim: To analyze the outcomes after transarterial chemoembolizaton (TACE) including radiological response and liver decompensation, and their predictive factors.
Methods: Sixty two hepatocellular carcinoma patients underwent transarterial chemoembolizaton. Laboratory data, tumor criteria, and Child-Pugh score were recorded baseline and at one month post-procedure. Tumor response according to Modified Response Evaluation Criteria in Solid Tumors was evaluated.
Results: Twenty five patients (40.3%) showed complete response, 15 patients (24.2 %) showed partial response, 2 patients (3.2%) showed stable disease, and 20 patients (32.3%) showed progressive disease. Significant difference was detected in patients with different radiological responses as regards tumor criteria (size, invasion of portal vein, Barcelona Clinic Liver Cancer stage), and technique of TACE. Thirty six patients (58%) had liver decompensation after TACE. Tumor criteria, serum bilirubin, AST, INR, Model for End Stage Liver Disease, and low platelet count were detected to be predictors of as radiological response and liver decompensation after TACE.
Conclusion: Radiological response cannot be considered alone to determine the outcomes after transarterial chemoembolization. Also, tumor criteria, liver functions, and platelet count are predictors of the outcome.
Nursing Diagnosis for Gastrointestinal/Digestive Diseases