Document Detail

Hepatotoxicity after transarterial chemoembolization and transjugular intrahepatic portosystemic shunt: do two rights make a wrong?
MedLine Citation:
PMID:  23176968     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To compare the rates of hepatotoxicity after transarterial chemoembolization for hepatocellular carcinoma (HCC) in patients with and without a transjugular intrahepatic portosystemic shunt (TIPS) who were stratified into comparable risk groups.
MATERIALS AND METHODS: A retrospective review of patients with HCC who were treated with transarterial chemoembolization between January 2005 and December 2009 was performed. Of 158 patients with comparable model for end-stage liver disease (MELD) scores, 10 had a patent TIPS. Hepatobiliary severe adverse events (SAEs) occurring after transarterial chemoembolization were documented. In addition, 1-year survival and liver transplantation rate after transarterial chemoembolization were calculated in each group.
RESULTS: The incidence of hepatobiliary SAEs after transarterial chemoembolization was nearly two times higher in patients with a TIPS (70%) than in patients without a TIPS (36%; P=.046). The liver transplantation rate 1 year after transarterial chemoembolization was 2.5 times higher in patients with a TIPS (80%) than in patients without a TIPS (32%; P=.004). There was no significant difference in 1-year survival between the two groups after transarterial chemoembolization.
CONCLUSIONS: Patients with HCC and a patent TIPS are more likely to develop significant hepatotoxicity after transarterial chemoembolization than comparable patients without a TIPS in place.
Maureen P Kohi; Nicholas Fidelman; David M Naeger; Jeanne M LaBerge; Roy L Gordon; Robert K Kerlan
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2012-11-22
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  24     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-31     Completed Date:  2013-07-09     Revised Date:  2013-08-19    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.
Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94143, USA.
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MeSH Terms
Aged, 80 and over
California / epidemiology
Carcinoma, Hepatocellular / mortality*,  therapy*
Chemoembolization, Therapeutic / mortality*
Combined Modality Therapy
Drug-Induced Liver Injury / mortality*
Liver Neoplasms / mortality*,  therapy*
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic / mortality*
Risk Factors
Survival Analysis
Survival Rate
Comment In:
J Vasc Interv Radiol. 2013 Jul;24(7):1075-6   [PMID:  23796100 ]
J Vasc Interv Radiol. 2013 Jul;24(7):1076   [PMID:  23796101 ]

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