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J Vasc Interv Radiol · Oct 2012
Comparative StudySafety and feasibility of same-day discharge of patients with unresectable hepatocellular carcinoma treated with doxorubicin drug-eluting bead transcatheter chemoembolization.
- Hasmukh J Prajapati, Shoaib Rafi, Bassel F El-Rayes, John S Kauh, David A Kooby, and Hyun S Kim.
- Division of Interventional Radiology and Image Guided Medicine, Department of Radiology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
- J Vasc Interv Radiol. 2012 Oct 1; 23 (10): 1286-93.e1.
PurposeThe aim of this study was to investigate the safety and feasibility of same-day discharge of patients with unresectable hepatocellular carcinoma (HCC) after doxorubicin drug-eluting bead (DEB) transarterial chemoembolization and to elucidate the factors predisposing to overnight admission.Materials And MethodsConsecutive patients with unresectable HCC who underwent superselective 100-300 μm DEB transarterial chemoembolization were included. The parameters of same-day therapy (group A) were compared with those of patients admitted overnight (group B). A χ2 test and a t test were used to compare categorical and continuous variables accordingly.ResultsSeventy-six patients (mean, 61 y) received 110 DEB transarterial chemoembolization treatments over an 8-month study period. In 84.5% (93/110) of DEB transarterial chemoembolization procedures, the patients were discharged on the same day (group A). The causes of hospitalization included the worsening of comorbidities in 41.1% (7/17), pain control in 29.4% (5/17), and groin and closure device-related complications in 29.4% (5/17) of patients. The mean Charlson comorbidity scores in groups A and B were 6.96 (standard deviation [SD] ± 1.98) and 8.47 (SD ± 2.18) (P = .0005), respectively. All of the patients in group B had Barcelona Clinic Liver Cancer (BCLC) stages C and D HCC (P = .024). There were no Common Terminology Criteria for Adverse Events (CTCAE) grade III or worse adverse events (AEs). There was no mortality or emergency visits within 30 days of discharge.ConclusionsSame-day discharge after superselective DEB transarterial chemoembolization for unresectable HCC is safe and feasible. BCLC C or D stage of disease, a higher Charlson comorbidity score, and groin or closure device complications are correlated with a greater likelihood for overnight admission.Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.
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