Efficacy and Safety of Transarterial Chemoembolization (TACE) in Patients with Hepatocellular Carcinoma (HCC) and Assessment of Health Related Quality of Life (HRQoL) using CLDQ©

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Ammara Abdul Majeed
Hafeezullah Shaikh
Syed Muhammad Zahid Azam
Nouman Al Qamri
Raheela Khalid
Abdul Basit Shaikh


Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality globally, with its management presenting significant clinical challenges, especially in advanced stages. Transarterial chemoembolization (TACE) offers a palliative treatment option, but the evidence on its impact on Health-Related Quality of Life (HRQoL) and its efficacy across different patient subgroups, particularly in elderly populations, remains limited.

Objective: This study aimed to assess the safety and efficacy of TACE in patients with HCC and evaluate its impact on HRQoL, focusing on patient subgroups including those with advanced age and varying stages of liver function.

Methods: In this prospective observational study, 140 patients with HCC undergoing TACE at a single center were enrolled. Patients were assessed for tumor response using the modified RECIST (mRECIST) criteria, complications post-TACE, changes in liver function as per Child-Pugh classification, and HRQoL using the Chronic Liver Disease Questionnaire (CLDQ). The association of tumor response with demographic and clinical factors was also analyzed. Statistical significance was determined using chi-square tests for categorical variables and paired t-tests for continuous variables.

Results: Tumor response rates were: Complete Response (CR) 14%, Partial Response (PR) 53.7%, Stable Disease (SD) 8.1%, and Progressive Disease (PD) 24.3%. Portal Vein Thrombosis (PVT) post-TACE was observed in 45.7% of patients. Immediate complications were predominantly vomiting (50%) and nausea (44.1%). At 6 weeks follow-up, anorexia (35.3%) and Post-embolization Syndrome (PSE) (19.9%) were the most common complaints. HRQoL showed significant improvement in all domains post-TACE (P=0.0001). Significant associations were found between tumor response and baseline BCLC stage, PVT status, and the use of Sorafenib, among other factors.

Conclusion: TACE demonstrates significant efficacy in improving tumor response and HRQoL in HCC patients, with a manageable safety profile. It is notably effective in younger patients, females, and those with less advanced disease. The study underscores the potential of TACE as a viable treatment option across a broader spectrum of HCC patients, including those traditionally considered at higher risk.

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How to Cite
Majeed, A. A., Shaikh, H., Azam, S. M. Z., Qamri, N. A., Khalid, R., & Shaikh, A. B. (2024). Efficacy and Safety of Transarterial Chemoembolization (TACE) in Patients with Hepatocellular Carcinoma (HCC) and Assessment of Health Related Quality of Life (HRQoL) using CLDQ©. Journal of Health and Rehabilitation Research, 4(1), 1678–1684. https://doi.org/10.61919/jhrr.v4i1.715
Author Biographies

Ammara Abdul Majeed, Dow University of Health Sciences (DUHS) Karachi Pakistan.

Postgraduate Trainee Gastroenterology, NILGID, Dow University of Health Sciences (DUHS), Karachi, Pakistan.

Hafeezullah Shaikh, Dow University of Health Sciences (DUHS) Karachi Pakistan.

MBBS, FCPS (Gastroenterology), Assistant Professor at NILGID, Dow University of Health Sciences (DUHS), Karachi, Pakistan.

Syed Muhammad Zahid Azam, Dow University of Health Sciences (DUHS) Karachi Pakistan.

MBBS, FCPS (Medicine), FCPS (Gastroenterology), MSc in Clinical Research, Head of Department NILGID, Dow University of Health Sciences (DUHS), Karachi, Pakistan.

Nouman Al Qamri, Dow University of Health Sciences (DUHS) Karachi Pakistan.

MBBS, FCPS (Radiology), Fellowship in Interventional Radiology, Assistant Professor Dow Institute of Radiology, Dow University of Health Sciences (DUHS), Karachi, Pakistan.

Raheela Khalid, Dow University of Health Sciences (DUHS) Karachi Pakistan

MBBS, FCPS Gastroenterology, Dow University of Health Sciences (DUHS), Karachi, Pakistan

Abdul Basit Shaikh, Dow University of Health Sciences (DUHS) Karachi Pakistan.

MBBS, House Officer at NILGID, Dow University of Health Sciences (DUHS), Karachi, Pakistan.


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