Textbook Outcome After Trans-arterial Chemoembolization for Hepatocellular Carcinoma


Mosconi, Cristina, O'Rourke, Joanne, Kloeckner, Roman, Sturm, Lukas, Golfieri, Rita, Celsa, Ciro, Fateen, Waleed, Odisio, Bruno C, Garanzini, Enrico Matteo, Peck-Radosavljevic, Markus et al (show 11 more authors) (2023) Textbook Outcome After Trans-arterial Chemoembolization for Hepatocellular Carcinoma. CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 46 (4). pp. 449-459.

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Abstract

<h4>Purpose</h4>Textbook Outcome (TO) is inclusive of quality indicators and it not been provided for trans-arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).<h4>Materials and methods</h4>Data on treatment-naïve HCC patients receiving TACE from 10 centers were reviewed. TO was defined as "no post-TACE grade 3-4 complications, no prolonged hospital stay (defined as a post-procedure stay ≤ 75th percentile of the median values from the total cohort), no 30-day mortality/readmission and the achievement of an objective response (OR) at post-TACE imaging." Grade of adverse event was classified according to the Common Terminology Criteria for Adverse Events and short-term efficacy was assessed by response. Pooled estimates were calculated to account for hospital's effect and risk-adjustment was applied to allow for diversity of patients in each center.<h4>Results</h4>A total of 1124 patients (2014-2018) fulfilling specific inclusion criteria were included. Baseline clinical features showed considerable heterogeneity (I<sup>2</sup> > 0.75) across centers. TACE-related mortality was absent in 97.6%, readmission was not required after 94.9% of procedures, 91.5% of patients had no complication graded 3-4, 71.8% of patients did not require prolonged hospitalization, OR of the target lesion was achieved in 68.5%. Risk-adjustment showed that all indicators were achieved in 43.1% of patients, and this figure was similar across centers. The median overall survival for patients who achieved all indicators was 33.1 months, 11.9 months longer than for patients who did not.<h4>Conclusions</h4>A useful benchmark for TACE in HCC patients has been developed, which provides an indication of survival and allows for a comparison of treatment quality across different hospitals.

Item Type: Article
Uncontrolled Keywords: Hepatocellular carcinoma, Trans-arterial chemoembolization, Survival, Complications, Morbidity, Textbook outcome, mRECIST
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 10 Aug 2023 15:17
Last Modified: 10 Aug 2023 15:17
DOI: 10.1007/s00270-023-03375-4
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3171834
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