The duration of the conventional chemoembolization for hepatocellular carcinoma: factors affecting the procedural time

Abstract

Aim: The present study evaluated the duration of chemoembolization in patients with hepatocellular carcinoma, analyzing possible factors affecting the procedural time. Methods: In total, 175 patients who underwent chemoembolization have been prospectively enrolled. The procedural length was considered the time between the insertion and the removal of the angiographic sheath. The features related to the tumor burden and angiographic procedures, which could be related to the procedural time, were recorded. Results: The chemoembolization time resulted in a mean of 58.1 min. The longer procedural time was associated with a number of nodules treated per patient ≥ 2 (P < 0.001), a number of segments with nodules ≥ 2 (P < 0.001), the presence of more than 1 nodule in the same segment (P < 0.001), the location of the tumor in the left lobe (P = 0.001), the exclusion from the Milan criteria (P < 0.001), and a number of segments treated ≥ 2 (P < 0.001). Only the number of nodules treated per patient resulted significantly in multivariate analysis (OR 2.927, 95%CI: 2.015-4.251, P < 0.001). Conclusion: The factors related to longer procedural time are the number of nodules treated ≥ 2, the number of segments with nodules ≥ 2, the involvement of the left lobe, the tumor burden outside the Milan criteria, and the number of segments treated ≥ 2. All these characteristics, known in the pre-procedural phase, represent useful tools for a correct planning of the angiographic room’s workflow during the pandemic era as well as in the future to reduce downtime and increase productivity.