Transarterial Chemoembolization of Hepatocellular Carcinoma: Propensity Score Matching Study Comparing Survival and Complications in Patients with Nonalcoholic Steatohepatitis Versus Other Causes Cirrhosis
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To evaluate the oncologic outcomes and complication profile in nonalcoholic steatohepatitis (NASH)-induced cirrhosis leading to hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).
Materials and Methods
Two hundred and twenty patients who underwent treatment of 353 HCCs were retrospectively reviewed, including 30 NASH patients who received TACE for 46 HCCs. Patient charts were evaluated for time to progression (TTP), complications and overall survival (OS). The group was split into NASH and non-NASH cohorts for comparison and additional analyses were done using propensity score matching (PSM).
Patients in the NASH cohort presented with significantly larger lesions (4.9 ± 5.8 cm vs 3.1 ± 2.4 cm, p = 0.05). There was no significant difference in TTP overall [Median NASH 396 days (95% CI 308–526 days) vs non-NASH cohort 307 days (95% CI 272–364), p = 0.25) or after PSM [259 days non-NASH (95% CI 215–490) vs 396 days NASH (95% CI (349–not reached), p = 0.43]. There was a non-significant increased OS in the non-NASH [median 1078 days (95% CI 668–1594)] as compared to the NASH cohort [median 706 days (95% CI 314–not reached)] (p = 0.08) which decreased following PSM [853 days (95% CI 526–1511) non-NASH vs 706 days (95% CI 314–not reached) NASH, p = 0.48]. The number of complications did not differ significantly between the two groups (p = 0.23).
The oncologic outcomes and complication profile of TACE for HCC induced by NASH cirrhosis appear to be similar to that of other etiologies of cirrhosis. NASH patients presented with larger tumors emphasizing the need for early surveillance.
KeywordsNonalcoholic fatty liver disease Chemoembolization Hepatocellular carcinoma
Research reported in this publication was supported by NIH Grant P30 CA77598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
This study was not supported by grant funding.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
Human and Animal Rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
This study has obtained IRB approval from the University of Minnesota and the need for informed consent was waive.
Consent for Publication
For this type of study, consent for publication is not required.
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