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. 2023 Nov 7:13:1256012.
doi: 10.3389/fonc.2023.1256012. eCollection 2023.

The impact of liver abscess formation on prognosis of patients with malignant liver tumors after transarterial chemoembolization

Yunan Wang  1 , Zhihui Chang  1 , Jiahe Zheng  1 , Zhaoyu Liu  1 , Jun Zhang  1
Affiliations

The impact of liver abscess formation on prognosis of patients with malignant liver tumors after transarterial chemoembolization

Yunan Wang et al. Front Oncol. .

Abstract

Purpose: Liver abscess is a rare and serious complication after transarterial chemoembolization (TACE) for liver cancer; however, its impact on the prognosis is unclear. This retrospective study examined the outcomes of patients with liver abscess formation following TACE for malignant liver tumors to elucidate the impact of liver abscess formation on the prognosis of these patients.

Methods: From January 2017 to January 2022, 1,387 patients with malignant tumors underwent 3,341 sessions of TACE at our hospital. Clinical characteristics of patients at baseline and follow-up were examined, including treatment and outcome of liver abscess, tumor response to the TACE leading to liver abscess, and overall survival time.

Results: Of 1,387 patients, 15 (1.1%) patients with liver abscess complications after TACE resulted in a total of 16 (0.5%) cases of liver abscess after 3,341 TACE sessions (including one patient with two events). After antibiotic or percutaneous catheter drainage (PCD) treatment, all the infections associated with liver abscesses were controlled. In the PCD group, eight patients died before drainage tube removal, one retained the drainage tube until the end of follow-up, and five underwent drainage tube removal; the mean drainage tube removal time was 149.17 ± 134.19 days. The efficacy of TACE leading to liver abscess was evaluated as partial response (18.75%), stable disease (37.5%), and progressive disease (43.75%). Eleven patients died during the follow-up period owing to causes unrelated to infections caused by liver abscesses. The survival rates at 3 months, 6 months, 1 year, and 5 years were 86.7%, 50.9%, 25.5%, and 17%, respectively.

Conclusion: Patients with liver abscess formation following TACE for malignant liver tumors experienced prolonged drainage tube removal time after PCD; while this condition did not directly cause death, it indirectly contributed to a poor prognosis in these patients.

Keywords: liver abscess; malignant liver tumors; percutaneous drainage; prognosis; transarterial chemoembolization.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Findings from a 62-year-old patient with liver metastasis of cholangiocarcinoma and a history of biliary-enteric anastomosis and one previous transarterial chemoembolization (TACE) session. (A) Before the TACE session, contrast-enhanced computed tomography scans revealed hypodense lesions in segment V of the liver, with no significant enhancement. A small amount of iodized-oil emulsion deposit was observed, and the intrahepatic bile duct showed multiple pneumobilia and dilatations. (B, C) Thirteen days after this TACE session, contrast-enhanced computed tomography scans revealed the formation of multiple gas-containing liver abscesses. (D, E) Subsequently, the patient underwent percutaneous drainage (PCD). (F) One month after PCD, contrast-enhanced computed tomography scans showed an increase in tumor size and multiple new metastases in the liver (arrow).
See this image and copyright information in PMC

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Grants and funding

The study was supported by the National Natural Science Foundation of China (Grant No. 81901856) and the 345 Talent Project of the Shengjing Hospital of China Medical University.
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