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Original article
DOI: 10.1016/j.cireng.2018.10.017
Complications of Transarterial Chemoembolization (TACE) in the Treatment of Liver Tumors
Complicaciones de la quimioembolización transarterial (QETA) en el tratamiento de los tumores hepáticos
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Alberto Marcacuzco Quintoa,
Corresponding author
alejandro_mq@yahoo.es

Corresponding author.
, Oana-Anisa Nutua, Ricardo San Román Mansob, Iago Justo Alonsoa, Jorge Calvo Pulidoa, Alejandro Manrique Municioa, Álvaro García-Sesmaa, Carmelo Loinaz Segurolaa, Javier Martínez Caballeroa, Luis Carlos Jiménez Romeroa
a Unidad de Cirugía Hepato-Bilio-Pancreática y Trasplante de Órganos Abdominales, Hospital Universitario 12 de Octubre, Departamento de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
b Servicio de Radiología, Hospital Universitario 12 de Octubre, Madrid, Spain
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Tables (3)
Table 1. Epidemiological, Clinics, Analytics and Radiological Characteristics of the Patients Treated With Transarterial Chemoembolization.
Table 2. Incidence of Complications and Adverse Effects Associated With Transarterial Chemoembolization.
Table 3. Characteristics of the Patients Who Developed Major Complications After Transarterial Chemoembolization.
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Abstract
Introduction

Transarterial chemoembolization (TACE) is considered a therapeutic option. It is mostly used in hepatocellular carcinoma or liver colorectal, neuroendocrine or melanoma metastases. Although it is considered a safe procedure, TACE presents complications, such as acute cholecystitis, which is the most common. Other procedure-related complications include pulmonary embolism, hepatic abscess, bile duct injury, gastric mucosa injury and, less frequently, acute pancreatitis. The aim of this study is to review the complications following TACE for liver tumors.

Methods

We performed a retrospective study including all the TACE procedures performed in a single center during the period between January 2013 and December 2016.

Results

Out of the 196 patients with liver tumors who had undergone 322 TACE, 258 (80%) were male and 64 (20%) were female. Mean patient age was 66.5 years. Major complications after chemoembolization included: decompensation with edema/ascites (6 patients), acute cholecystitis (4), acute pancreatitis (3), liver rupture (1), liver abscess (1) and renal failure (1). Postembolization syndrome appeared in 71 (20%) patients. On multivariate analysis, it was observed that concomitant cardiovascular disease (OR: 4.5; 95% CI: 1.2–17; P=.025) is a risk factor for the development of complications.

Conclusions

TACE is a safe and effective procedure for liver tumor treatment. The majority of the complications are rare and present a low incidence of mortality.

Keywords:
Transarterial chemoembolization
Complications
Hepatocellular carcinoma
Resumen
Introducción

La quimioembolización transarterial (QETA) es considerada una opción terapéutica utilizada en el tratamiento del carcinoma hepatocelular y de las metástasis hepáticas secundarias del carcinoma colorrectal, tumores neuroendocrinos y melanoma ocular. Aunque es un procedimiento seguro, no está exento de complicaciones, siendo la más frecuente la colecistitis aguda. Otras complicaciones descritas son el tromboembolismo pulmonar, el absceso hepático, lesiones de la mucosa gastrointestinal, lesiones de la vía biliar, etc. El objetivo principal del estudio es revisar y describir las complicaciones derivadas de la QETA en el tratamiento de los tumores hepáticos.

Métodos

Se ha realizado un análisis retrospectivo de todas las QETA practicadas en nuestro centro entre enero de 2013 y diciembre de 2016. En dicho periodo se realizaron 322 QETA en 196 pacientes.

Resultados

Del total de procedimientos, 258 (80%) fueron realizados en hombres y 64 (20%) en mujeres. Además, la edad media de los pacientes fue de 66,5años. Las complicaciones mayores derivadas de la QETA fueron descompensación edemo-ascítica (6casos), colecistitis aguda (4), pancreatitis aguda (3), rotura hepática (1), absceso hepático (1) y deterioro de la función renal (1). Además, el síndrome postembolización se objetivó en 71 (22%) casos. En el análisis multivariante se observó que el antecedente cardiovascular (OR: 4,5; IC95%: 1,2-17; p=0,025) es un factor de riesgo para el desarrollo de complicaciones post-QETA.

Conclusiones

Las complicaciones derivadas de la QETA son poco frecuentes y con una baja incidencia de mortalidad.

Palabras clave:
Quimioembolización transarterial
Complicaciones
Carcinoma hepatocelular

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