Effect of Transarterial Chemoembolization in Hepatocellular Carcinoma with Respect to Tumor Size: A Prospective Observational Study

Author(s): Muhammad Sohaib Asghar, Sarah Kamran Akbani, Noman Ahmed Khan, Syed Jawad Haider Kazmi, Mohammed Akram, Rumael Jawed, Maira Hassan, Uzma Rasheed

Hepatocellular carcinoma is ranked as the sixth most common cancer globally. It also accounts for the second leading determinant of cancer-related mortalities worldwide. In the present day, transarterial chemoembolization (TACE) is the treatment modality of preference for high burden hepatocellular carcinoma. Our study aims to report the efficacy of TACE and alterations in laboratory parameters in patients of hepatocellular carcinoma before and after undergoing TACE in lieu with size >3 cm or <3 cm of the tumor. This prospective observational study was prosecuted in medicine, gastroenterology and hepatology department including 167 patients who were previously diagnosed with hepatocellular carcinoma by radiological imaging, and have undergone TACE. The mean age of the study population is 53.89 ± 10.58 with females elder than males (p=0.038). The most frequent cause was Hepatitis C (p<0.001). Total bilirubin was found more in <3 cm tumor size (p=0.052) while decreased platelets were more a feature of >3cm tumor size (p=0.050). After TACE, bilirubin levels were remarkably improved in <3 cm tumor size, while INR and Platelets equally improved in both the groups and serum albumin and serum sodium was comparatively more improved in >3cm tumor size. Serum creatinine worsened in <3cm tumor size while improved in >3 cm tumor size, and SGPT was indifferent in <3cm tumor size and worsened in >3cm tumor size. Mean meld score was found improved in both the study groups however, greater improvements were seen in >3cm tumor size group. Downstaging of child-pugh classes was statistically significant in both the study groups (p<0.001).