Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular Carcinoma
Purpose To determine the association between frailty, 30-day complications, rehospitalization, and transplant-free survival (TFS) following conventional and drug-eluting bead transarterial chemoembolization. Materials and Methods A retrospective analysis was performed on a cohort of 125 p...
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| Format: | Article |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2023-04-01
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| Series: | Journal of Clinical Interventional Radiology ISVIR |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1745775 |
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| author | Rana Rabei Parmede Vakil Bradley King R. Peter Lokken Michael Heller Nicholas Fidelman Maureen Kohi |
| author_facet | Rana Rabei Parmede Vakil Bradley King R. Peter Lokken Michael Heller Nicholas Fidelman Maureen Kohi |
| author_sort | Rana Rabei |
| collection | DOAJ |
| description | Purpose To determine the association between frailty, 30-day complications, rehospitalization, and transplant-free survival (TFS) following conventional and drug-eluting bead transarterial chemoembolization.
Materials and Methods A retrospective analysis was performed on a cohort of 125 patients with treatment-naïve hepatocellular carcinoma who underwent conventional or drug-eluting beads chemoembolization at our institution between 2014 and 2015. Liver function parameters, Barcelona clinic liver cancer tumor stage, and all components of the five-item modified frailty index (mFI-5) were used to determine the patient's frailty status. Key end points included severe (grade 3 or above) adverse events of chemoembolization, 30-day rehospitalization rates, and TFS. Logistic regression analysis was performed on conventional predictors of postoperative complications after chemoembolization. Median survival was estimated and compared using the Kaplan–Meier's estimator and log-rank test.
Results Among 125 patients who underwent first-time chemoembolization, higher frailty score was an independent predictor of both 30-day hospital readmission and severe liver toxicity (p = 0.01 and p = 0.03, respectively) on multivariate logistic regression analysis. Each point increase in mFI-5 conferred a threefold or twofold increase in the risk of experiencing 30-day rehospitalization or postoperative severe adverse events, respectively. At the data censor date, patients with mFI-5 score ≥ 2 had decreased overall TFS (28.1 vs. 39.8 months, p = 0.03).
Conclusion Increasing frailty as determined by mFI-5 is an independent predictor of 30-day complications and lower TFS following chemoembolization. |
| format | Article |
| id | doaj-art-8906a41d4d3d4d469673d7c07eb3d99d |
| institution | OA Journals |
| issn | 2456-4869 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Clinical Interventional Radiology ISVIR |
| spelling | doaj-art-8906a41d4d3d4d469673d7c07eb3d99d2025-08-20T01:58:33ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Clinical Interventional Radiology ISVIR2456-48692023-04-01070102703310.1055/s-0042-1745775Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular CarcinomaRana Rabei0Parmede Vakil1Bradley King2R. Peter Lokken3Michael Heller4Nicholas Fidelman5Maureen Kohi6Department of Interventional Radiology, University of California, San Francisco, San Francisco, California, United StatesDepartment of Interventional Radiology, University of California, San Francisco, San Francisco, California, United StatesDepartment of Interventional Radiology, University of California, San Francisco, San Francisco, California, United StatesDepartment of Interventional Radiology, University of California, San Francisco, San Francisco, California, United StatesDepartment of Interventional Radiology, University of California, San Francisco, San Francisco, California, United StatesDepartment of Interventional Radiology, University of California, San Francisco, San Francisco, California, United StatesDepartment of Radiology, University of North Carolina, Chapel Hill, North Carolina, United StatesPurpose To determine the association between frailty, 30-day complications, rehospitalization, and transplant-free survival (TFS) following conventional and drug-eluting bead transarterial chemoembolization. Materials and Methods A retrospective analysis was performed on a cohort of 125 patients with treatment-naïve hepatocellular carcinoma who underwent conventional or drug-eluting beads chemoembolization at our institution between 2014 and 2015. Liver function parameters, Barcelona clinic liver cancer tumor stage, and all components of the five-item modified frailty index (mFI-5) were used to determine the patient's frailty status. Key end points included severe (grade 3 or above) adverse events of chemoembolization, 30-day rehospitalization rates, and TFS. Logistic regression analysis was performed on conventional predictors of postoperative complications after chemoembolization. Median survival was estimated and compared using the Kaplan–Meier's estimator and log-rank test. Results Among 125 patients who underwent first-time chemoembolization, higher frailty score was an independent predictor of both 30-day hospital readmission and severe liver toxicity (p = 0.01 and p = 0.03, respectively) on multivariate logistic regression analysis. Each point increase in mFI-5 conferred a threefold or twofold increase in the risk of experiencing 30-day rehospitalization or postoperative severe adverse events, respectively. At the data censor date, patients with mFI-5 score ≥ 2 had decreased overall TFS (28.1 vs. 39.8 months, p = 0.03). Conclusion Increasing frailty as determined by mFI-5 is an independent predictor of 30-day complications and lower TFS following chemoembolization.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1745775oncologyfrailtytace |
| spellingShingle | Rana Rabei Parmede Vakil Bradley King R. Peter Lokken Michael Heller Nicholas Fidelman Maureen Kohi Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular Carcinoma Journal of Clinical Interventional Radiology ISVIR oncology frailty tace |
| title | Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular Carcinoma |
| title_full | Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular Carcinoma |
| title_fullStr | Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular Carcinoma |
| title_full_unstemmed | Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular Carcinoma |
| title_short | Frailty as a Predictor of Complications and Transplant-Free Survival after Transarterial Chemoembolization of Hepatocellular Carcinoma |
| title_sort | frailty as a predictor of complications and transplant free survival after transarterial chemoembolization of hepatocellular carcinoma |
| topic | oncology frailty tace |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1745775 |
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