8:18 AM; Abstract No. 82 - Safety of outpatient-based transarterial chemoembolization for hepatocellular carcinoma in B and Child-Pugh C patients

Abstract

Purpose: To evaluate the safety of outpatient-based transarterial chemoembolization (TACE) for hepatocellular carcinoma in patients with intermediate (Child-Pugh B) and advanced (Child-Pugh C) liver disease. Materials and Methods: This is a single-center retrospective review of all HCC patients with Child-Pugh B (intermediate) or Child-Pugh C (advanced) cirrhosis who underwent TACE over a 46-month period. Sixty-nine consecutive chemoembolizations in 26 patients with intermediate and advanced liver disease were reviewed. Patients were classified as outpatients if they were discharged on the day of the procedure or as inpatients if they were admitted overnight. A comprehensive database and chart review of post-procedure telephone interviews, clinic visits, and hospital admissions was performed. The end-points of the study were (1) re-admission to the hospital within 48 hours of discharge, or (2) an emergency department visit within 48 hours of discharge. Results: Between July 2009 and October 2011, inpatient TACE treatments were performed in 5 patients with advanced cirrhosis and 9 patients with intermediate disease. Outpatient TACE treatments were performed in 6 patients with intermediate disease. After October 2011, 49 consecutive outpatient TACE treatments were performed in patients with advanced (10) and intermediate (39) cirrhosis. Safety endpoints of an emergency department visit or hospital readmission were identified in a single Child-Pugh B outpatient who returned to the ED within 48 hours for symptoms related to ascites. No patients from either group required readmission. Conclusion: Transarterial chemoembolization can be safely performed in the outpatient setting for patients with intermediate (Child-Pugh B) and advanced (Child-Pugh C) liver disease in an Interventional Radiology practice with close follow-up.