Table 59Adverse events associated with local hepatic therapies: TACE compared with TEA (TAE), case series studies

Study
Rating
Group
N
Liver Failure %Hepatic Hemorrhage %Hepatic Abscess %Rare AE, N (%)
Bargellini et al. 201164
Fair
TACE
67
3NRNRNR
Buijs et al. 200865
Fair
TACE
190
2.6NR0.5Fatal variceal bleeding in 1 patient 4 weeks after TACE; MI in 1 patient 2 days after TACE;
Giannini et al.201068
Poor
TACE
128
NRNRNRNR
Guiu et al. 200969
Fair
TACE
43
NRNRNR1 case (1%) of bowel perforation (grade 5), 2 cases (1%) of severe sepsis without leucopenia (grade 5), ischemic cholecystitis 2 (1%), gastric ulcer 1 (1%), 2 (1%) cardiac toxicity, 2 (1%), 3 (7%) treatment related deaths
Imai et al. 201170
Poor
TACE
122
NRNRNRGrade 4 decrease in neutrophil count 1 (1%), increased AST 4 (3%), increase ALT 1 (1%), all resolved in two weeks
Kawaoka et al. 200972
Poor
TACE*
107
NRNR0NR
Kim et al. 201283
Poor
TACE
2
NRNRNRReactivated tuberculosis in both cases
Leelawat et al. 200873
Poor
TACE
15
NRNRNRNR
Mabed et al. 200975
Fair
TACE
50
22NR2Puncture site bleeding and subsequent hematoma occurred in 3 patients (6%). Hypotension and bradycardia in 1 patient (2%). Two patients (4%) suffered GI bleeds due to ruptured esophageal varices. 1 (2%) patient developed cholecystitis.
Maeda et al. 200876
Fair
TACE
33
NRNRNRGrade 3 hepatic arterial disease (15%)
Molinari et al. 200678
Poor
TACE
40
NRNRNRMajor adverse events:
Partial PVT 3 (3.7%), Upper GI bleeding 3 (3.7%), Dehydration and cachexia requiring readmission 3 (3.7%), Flare of hepatitis B virus hepatitis 1 (1.2%), Neutropenic fever requiring parenteral antibiotics 1 (1.2%), Femoral artery pseudo aneurysm 1 (1.2%), Paraduodenal chemotherapy extravasation 1 (1.2%), Psoas muscle abscess 1 (1.2%)
Mortality within 30 days post treatment:
Myocardial infarction at 3 weeks 1 (1.2%), Neutropenic pneumonia complicated by sepsis 1 (1.2%)
Reso et al. 200984
Poor
TACE
1
NRNRNRTumor rupture resulting in intraperitoneal bleeding 1 (100%); developed post-embolization syndrome 1 (100%); Patient died of respiratory failure 16 days following TACE.
Wu et al. 201081
Poor
TACE
110
NRNRNRGrade 3 or 4: bilirubin toxicity 18 (13.6%), alanine aminotransferase toxicity 17 (12.8%), aspartate aminotransferase toxicity 25 (18.9%), white blood cell toxicity 3 (2.3%), platelet toxicity 1 (0.8%)
Death possibly related to treatment, arm not reported 1 (0.75%)
Zhang et al. 201182
Good
TACE
277
0.4NRNRTumor rupture in 1 (0.4%), GI bleeding in 2 (0.7%)
Wu et al. 201081
Poor
TACE with 131 I-metuximab
132
NRNRNRGrade 3 or 4: bilirubin toxicity 13 (11.8%), alanine aminotransferase toxicity 17 (15.5%), aspartate aminotransferase toxicity 22 (20%), white blood cell toxicity 6 (5.5%), platelet toxicity 8 (7.2%)
Death possibly related to treatment, arm not reported 1 (0.75%)
Leelawat et al. 200873
Poor
TACE-Doxorubicin
15
NRNRNRNR
Pietrosi et al. 200949
Poor
TACE or TAE
320
0.3NRNR2(1%) ischemic cholecystitis, 1 (1%)gastric ulcer, 1 (1%)bowel perforation, 4 (3%) edemo-ascitic decompensation, 1 (1%) gastrointestinal hemorrhage, 2 (1%) cardiac toxicity, 2 (1%) severe sepsis, 3 (7%) treatment related deaths
Rand et al. 200579
Good
TAE
46
2.2NR2.2NR
*

No grade 3 or 4 adverse events of interest were observed for these treatment groups.

Abbreviations: AE = adverse events; ALT = alanine aminotransferase; AST = aspartate transaminase; GI = gastrointestinal; HCC = hepatocellular carcinoma; MI = myocardial infarction; N = number of patients; NR = not reported; PVT = portal vein thrombosis; TACE = transarterial chemoembolization; TAE = transarterial alcohol embolization.

From: Results

Cover of Local Therapies for Unresectable Primary Hepatocellular Carcinoma
Local Therapies for Unresectable Primary Hepatocellular Carcinoma [Internet].
Comparative Effectiveness Reviews, No. 114.
Belinson S, Yang Y, Chopra R, et al.

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