Abstract
Background
Hepatic failure is a potentially fatal complication in hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE). However, there is a lack of clear predictive factors for hepatic failure after TACE in HCC patients.
Aims
The purpose of this study was to complete a systematic review and meta-analysis of the factors associated with post-TACE hepatic failure.
Methods
Medline and Embase databases were searched for original articles reporting predictive factors for hepatic failure after TACE. Mean differences (MD) or odds ratios (OR) were derived for each predictor and pooled using random-effects meta-analyses.
Results
Of 2,680 studies screened, a total of 1,654 patients across 9 studies were included in meta-analyses. Albumin (MD = 0.34, 95%CI -0.62-(-0.06)), total bilirubin (TB) (MD = 0.65, 95%CI 0.01–1.28), platelets count (MD = -15.82, 95%CI -20.91-(-10.72)), AFP (MD = 74.05, 95%CI 64.12–83.99), Model for End-Stage Liver Disease (MELD) (MD = 3.4, 95%CI 1.33–5.48), Child-Pugh score (CTP score) (MD = 1.06, 95%CI 0.84–1.28), CTP class (OR = 4.64, 95%CI 1.2-17.96), tumor size (MD = 7.75, 95%CI 6.87–8.63), portal vein thrombosis (OR = 1.78, 95%CI 1.19–2.67), and indocyanine green retention test after 15 minutes (ICG-R15 test) (MD = 16.58, 95%CI 11.92–21.24) were associated with hepatic failure after TACE.
Conclusions
In this meta-analysis, factors associated with hepatic failure in HCC patients undergoing TACE include low albumin and platelets, high TB, AFP, MELD score, CTP score and class, tumor size, presence of portal vein thrombosis and the high values of ICG-R15 test.