Background: The real-world incidence of chronic liver damage after transarterial chemoembolization (TACE) is\nunclear. LiverT, a retrospective, observational study, assessed liver function deterioration after a single TACE in\nreal-world hepatocellular carcinoma (HCC) patients in US practice.\nMethods: Eligible HCC patients identified from Optumâ??s integrated database using standard codes as having had\nan index TACE between 2010 and 2016 with no additional oncologic therapy in the subsequent 3 months. At least\none laboratory value (bilirubin, albumin, aspartate transaminase [AST], alanine transaminase [ALT], international\nnormalized ratio [INR]) was required at baseline and the acute (less than equal to29 days after TACE) and chronic (30-90 days after\nTACE) periods. Due to lack of universally accepted liver function deterioration criteria, clinically meaningful changes\nin laboratory parameters were pre-defined by authors (FP, RM, and SO).\nResults: Of the 3963 TACE patients, 572 were eligible for analyses. Deterioration of liver function from baseline\noccurred in the acute period and persisted in the chronic period (bilirubin 30 and 23%, albumin 52 and 31%, AST\n44 and 25%, ALT 43 and 25%, INR 25 and 15%, respectively). In a subgroup analysis, a higher proportion of patients\nwith diabetes had deterioration in AST and ALT.\nConclusions: A clinically meaningful proportion of real-world HCC patients had deterioration of liver function-related\nlaboratory values 30-90 days after a single TACE in modern US practice. Future electronic health record research may\nhelp determine causality. The present findings highlight the need for the careful selection of patients for TACE, which is\nimportant to help optimize the benefit of the overall HCC treatment course.
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