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Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease
Poor outcomes of hepatocellular carcinomas (HCC) in chronic kidney disease (CKD) patients are well described. Transarterial therapy is the standard treatment for HCC, following which regular contrast-enhanced imaging for residual disease is recommended. CKD is considered a relative contraindication...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736401/ https://www.ncbi.nlm.nih.gov/pubmed/31464957 http://dx.doi.org/10.1097/MD.0000000000017007 |
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author | Lin, Wei-Chen Chang, Chen-Wang Chang, Ching-Wei Wang, Tsang-En Chen, Ming-Jen Wang, Horng-Yuan |
author_facet | Lin, Wei-Chen Chang, Chen-Wang Chang, Ching-Wei Wang, Tsang-En Chen, Ming-Jen Wang, Horng-Yuan |
author_sort | Lin, Wei-Chen |
collection | PubMed |
description | Poor outcomes of hepatocellular carcinomas (HCC) in chronic kidney disease (CKD) patients are well described. Transarterial therapy is the standard treatment for HCC, following which regular contrast-enhanced imaging for residual disease is recommended. CKD is considered a relative contraindication for transarterial therapy owing to renal failure. This retrospective study investigated the outcomes of transarterial therapy in HCC patients with CKD. In total, 132 HCC patients who received transarterial therapy were enrolled, of whom 36 had CKD. Most CKD patients were elderly, with mean age of diagnosis of 69.7 ± 11.4 years. Hypertension (odds ratio [OR]; 5.06; 95% confidence interval [Cl]; 1.83–13.94), hepatitis C virus carrier rate (OR; 4.12, 95% CI; 1.13–14.99) and diabetes (OR; 3.62, 95% CI; 1.22–10.72) were significant predictors for CKD in HCC patients. Post therapy, the estimated glomerular filtration rate significantly decreased 13.7% from baseline in the CKD patients (P = .03). There were more post-therapy complications than in the non-CKD group, e.g. acute renal failure and sepsis (P < .01 vs P < .01). Overall survival in the CKD group was significantly poor (10.9 ± 8.5 vs 23.5 ± 16.3 months, P < .01). The lower survival of CKD patients was unrelated to treatment modality or less contrast-enhanced imaging follow-up. Further research on patient care and factors leading to poor outcomes for CKD is needed. |
format | Online Article Text |
id | pubmed-6736401 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67364012019-10-02 Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease Lin, Wei-Chen Chang, Chen-Wang Chang, Ching-Wei Wang, Tsang-En Chen, Ming-Jen Wang, Horng-Yuan Medicine (Baltimore) 4500 Poor outcomes of hepatocellular carcinomas (HCC) in chronic kidney disease (CKD) patients are well described. Transarterial therapy is the standard treatment for HCC, following which regular contrast-enhanced imaging for residual disease is recommended. CKD is considered a relative contraindication for transarterial therapy owing to renal failure. This retrospective study investigated the outcomes of transarterial therapy in HCC patients with CKD. In total, 132 HCC patients who received transarterial therapy were enrolled, of whom 36 had CKD. Most CKD patients were elderly, with mean age of diagnosis of 69.7 ± 11.4 years. Hypertension (odds ratio [OR]; 5.06; 95% confidence interval [Cl]; 1.83–13.94), hepatitis C virus carrier rate (OR; 4.12, 95% CI; 1.13–14.99) and diabetes (OR; 3.62, 95% CI; 1.22–10.72) were significant predictors for CKD in HCC patients. Post therapy, the estimated glomerular filtration rate significantly decreased 13.7% from baseline in the CKD patients (P = .03). There were more post-therapy complications than in the non-CKD group, e.g. acute renal failure and sepsis (P < .01 vs P < .01). Overall survival in the CKD group was significantly poor (10.9 ± 8.5 vs 23.5 ± 16.3 months, P < .01). The lower survival of CKD patients was unrelated to treatment modality or less contrast-enhanced imaging follow-up. Further research on patient care and factors leading to poor outcomes for CKD is needed. Wolters Kluwer Health 2019-08-30 /pmc/articles/PMC6736401/ /pubmed/31464957 http://dx.doi.org/10.1097/MD.0000000000017007 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | 4500 Lin, Wei-Chen Chang, Chen-Wang Chang, Ching-Wei Wang, Tsang-En Chen, Ming-Jen Wang, Horng-Yuan Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease |
title | Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease |
title_full | Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease |
title_fullStr | Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease |
title_full_unstemmed | Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease |
title_short | Challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease |
title_sort | challenges of transarterial therapy for hepatocellular carcinoma in patients with chronic kidney disease |
topic | 4500 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736401/ https://www.ncbi.nlm.nih.gov/pubmed/31464957 http://dx.doi.org/10.1097/MD.0000000000017007 |
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