Prediction of transarterial chemoembolization (TACE) outcome by pre- and postinterventional 13C-methacetin breath test

Senk, Karin and Wilcke, Juliane and Haimerl, Michael and Verloh, Niklas and Bartulos, Carolina Rio and Baeumler, Wolf and Stroszczynski, Christian and Wiggermann, Philipp (2021) Prediction of transarterial chemoembolization (TACE) outcome by pre- and postinterventional 13C-methacetin breath test. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 79 (1). pp. 73-80. ISSN 1386-0291, 1875-8622

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Abstract

BACKGROUND AND OBJECTIVE: Liver function is one of the most important parameters for the outcome of transarterial chemoembolization (TACE). The liver maximum capacity (LiMAx) test is a bedside test that provides a real-time option for liver function testing. The objective of this pilot study was to investigate the suitability of the LiMAX test for predicting the TACE outcome. METHODS: 20 patients with intermediate-stage hepatocellular carcinoma (HCC) received a LiMAx test 24 h pre and post TACE. In addition, laboratory values were collected to determine liver function and model for endstage liver disease (MELD) scores. The success of TACE was assessed 6 weeks post intervention by morphological imaging tests using modified response evaluation criteria in solid tumors (mRECIST). RESULTS: Patients with an objective response (OR = CR+ PR) according to mRECIST post TACE had significantly higher values in the pre-interventional LiMAx test than patients with a non-OR (PD or SD) post TACE (r(14) = 0.62, p = 0.01). Higher pre-interventional LiMAx values therefore indicate OR. Patients with a disease control (DC = CR+ PR+ SD) according to mRECIST post TACE had significantly higher values in the pre-interventional LiMAx test than patients with a non-DC (PD) post TACE (r(14) = 0.65, p = 0.01). Higher pre-interventional LiMAx values therefore indicate DC. The point biserial correlations of LiMAx values pre and post TACE with the outcome OR or DC were descriptively stronger than those of MELD with OR or DC. This suggests that the LiMAx test correlates better with the treatment response than the MELD score. CONCLUSIONS: For the first time, we were able to show in our study that patients who are scheduled for TACE could benefit from a LiMAx test to be able to estimate the benefit of TACE. The higher the pre-interventional LiMAx values, the higher the benefit of TACE. On the other hand, laboratory parameters summarized in the form of the MELD score had significantly less descriptive correlation with the TACE outcome.

Item Type: Article
Uncontrolled Keywords: HEPATOCELLULAR-CARCINOMA; LIVER-FUNCTION; MRECIST; HEPATECTOMY; SAFETY; TACE; LiMAx; HCC; MRECIST; methacetin breath test; liver function; outcome
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Röntgendiagnostik
Depositing User: Dr. Gernot Deinzer
Date Deposited: 22 Aug 2022 07:23
Last Modified: 22 Aug 2022 07:23
URI: https://pred.uni-regensburg.de/id/eprint/46275

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