HPB P57 Outcomes of Transarterial Chemoembolization (TACE) at East Lancashire Hospitals NHS Trust

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Abstract Background Hepatocellular carcinoma (HCC) accounts for 85%–90% of all primary liver cancers and is a significant cause of morbidity and mortality worldwide. The aim of this study was to evaluate the efficacy and safety of the procedure at ELHT. TACE is an image-guided IR locoregional therapy for unresectable hepatocellular carcinoma patients to improve their survival. It has emerged as an efficacious palliative option for inoperable cases as it is less invasive and known to have fewer complications. It may also act as a bridge for liver transplantation. Methods This is a retrospective study with data collected over 2 years. Treatment-naive patients aged 18 and above with unresectable HCC with a Child-Pugh Class A/B were selected. Treatment response was assessed after every TACE session using CT or MRI within 6 weeks of TACE, according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Safety was assessed based on technical success and the number of complications. Results 35 patients underwent TACE (median age - 79). The commonest underlying etiologies were liver cirrhosis (25%) and alcohol (22%). Of the total 90 sessions, partial response was seen in 44% (39 sessions) followed by complete response in 23% (21). For 22% (20), the outcome was stable disease. Since 74% of the patients had multiple sessions, efficacy per patient showed a result of complete response in 44% and partial response in 18%.1 year survival rate was 60%, 21% had a recurrence and 22.8% developed complications (3 liver abscesses). The technical success achieved was 97.7%. Conclusions TACE is safe and effective for treating HCC patients, who are unsuitable for thermal ablation or surgery as it offers comparable survival benefits. ELHT showed a successful disease control (complete, partial response + stable disease) of 89% through TACE. Liver abscess was the commonest compilation in our study (22%) - this was higher when compared with the existing literature (an average of approximately 6%).