Change in Liver Function after Selective Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma:...

Liver function deterioration after transarterial chemoembolization (TACE) may preclude systemic therapy. The JIVROSG-1302 PRESIDENT study, a prospective, randomized controlled trial, showed a significantly higher local complete response rate with selective conventional TACE (cTACE) than with selective TACE using drug-eluting beads (DEB-TACE). However, this study did not assess the changes in liver function after selective TACE. The purpose of this study, JIVROSG-2001 PRESIDENT-ALBI, was to evaluate the change in liver function after selective TACE for unresectable hepatocellular carcinoma (HCC) using the same patient cohort.

The primary endpoint was ALBI grade deterioration rate after 3 months of TACE compared to DEB-TACE and cTACE. Secondary endpoints included the ALBI grade and score change and the identification of risk factors associated with liver function deterioration.

A total of 197 patients with unresectable HCC were enrolled in this study. The ALBI grade deterioration rate at 3 months was 11% for the DEB-TACE group and 6% for the cTACE group, with no significant difference (p = 0.203). The mean ALBI score deterioration at 1 and 3 months was 0.06 and 0.02, respectively, and no notable deterioration in liver function was observed. The risk factors for ALBI score deterioration 1 month after selective TACE included large tumor diameter, high number of treated tumors, and treated vessels.

Selective TACE, whether DEB-TACE or cTACE, did not significantly impair the liver function. Even with selective TACE, larger tumors, multiple tumors, and a large number of treated blood vessels were associated with worsening liver function 1 month after TACE.