P-44 TRANSARTERIAL CHEMOEMBOLIZATION IN PATIENTS WITH CONTROVERSIAL INDICATION

Introduction

Transarterial chemoembolization (TACE) is considered the therapy of choice in patients with intermediate stage hepatocellular carcinoma (HCC) who are not candidates for surgical resection or tumor ablation. There are discrepancies in the American and European consensus on the treatment of HCC in Child B stage patients, given it is associated with an increased risk of liver failure and death.

Objective

To describe the experience of a University Center in the management of patients with HCC and cirrhosis Child B.

Methods

Observational, retrospective study. 25 patients were included. Sociodemographic variables, aetiology of cirrhosis, HCC stage, treatment and associated decompensations were included. The analysis was carried out with descriptive statistics.

Results

Of the patients, 14 women, 24% with MELD-Na ≥ 15 (15-20). 44% NASH, 20% HCV infection. 56% and 34% in stage A and B of Barcelona. 32% within the Milan criteria and 25% within San Francisco. After the TACE, 16% presented immediate complications, without associated mortality. At 6 months of follow-up, 36% presented an increase in MELD-Na by (2-6) points, 32% presented or increased ascites, 12% progressed to Child C. Survival at 6 months after chemoembolization was 76%.

Conclusion

TACE was a safe procedure in patients with Child B, in terms of immediate complications, however, a considerable percentage presented deterioration of liver function at 6 months of follow up. This therapy in Child B patients should be evaluated individually case by case.