Key result
Transarterial chemoembolization in patients with unresectable HCC was associated with decreased left ventricular ejection fraction across all tumor response groups.
Why the study?
The study was conducted to assess the effect of transarterial chemoembolization on cardiopulmonary functions in patients with unresectable hepatocellular carcinoma.
Does transarterial chemoembolization (TACE) affect cardiopulmonary functions in patients with unresectable hepatocellular carcinoma?
Cohort (n=300)
Does transarterial chemoembolization (TACE) affect cardiopulmonary functions in patients with unresectable hepatocellular carcinoma?
TACE for unresectable HCC is associated with early deleterious cardiopulmonary effects, including reduced LVEF and increased lung restriction, suggesting a need for cardiopulmonary monitoring.
Answers are grounded in this paper and cite their sources.
May warrant post-TACE echocardiographic surveillance in unresectable HCC; leaves open causal impact pending prospective trials.
To assess the effect of transarterial chemoembolization (TACE) on cardiopulmonary functions in patients with unresectable hepatocellular carcinoma (HCC). This prospective cohort study included 300 patients with unresectable HCC candidate for treatment by TACE. Pulmonary function tests (PFT) and echocardiography were evaluated one day before and one month after TACE. Assessment of response to TACE was according to modified Response Evaluation Criteria in Solid Tumor (mRECIST) evaluated by triphasic computed tomography (CT) or dynamic magnetic resonance image (MRI) one month after TACE. TACE produced significant increase in lung restriction in patients achieved partial response (PR) (P = 0.002) and patients with stable disease (SD) (P = 0.014) but no significant changes occurred in patients achieved complete response (CR). Left ventricular strain was observed in patients achieved CR as a decrease in left ventricular ejection fraction (LVEF) (P = 0.01) and global longitudinal scale (GLS) (P = 0.001), PR as a decrease in LVEF (P = 0.003) and GLS (P < 0.0001), and those with SD as a decrease in LVEF (P < 0.0001). TACE has some deleterious cardiopulmonary effects that can be assessed by echocardiography and PFT. Patients with PR and SD could be evaluated for FVC and LVEF before a second TACE session.
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Farid et al. (2021) conducted a cohort in Unresectable hepatocellular carcinoma (n=300). Transarterial chemoembolization (TACE) vs. Baseline (one day before TACE) was evaluated on Cardiopulmonary functions (pulmonary function tests and echocardiography). Transarterial chemoembolization in patients with unresectable HCC was associated with decreased left ventricular ejection fraction across all tumor response groups.
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