No patient needed hemodialysis treatment from a renal complication. Hepatic complications from the treatment were transient with normalization of biochemical disturbances within a week. Table 3 Adverse events during hospitalization after TACE treatment in 271 patients Overall survival Survival was analyzed using as a start time the date that patients had their first TACE treatment and the unit of analysis was the patient (n=157). The differences Inhibitors,research,lifescience,medical of survival over time based on the presence of cytolysis are displayed in Kaplan-Meier curve (Figure 1). Our strategy for model selection took into account the limited number of death events. We restricted the number of variables

in the model to include cytolysis, age, the AFP values, MELD score and a tumour prognostic score (CLIP or Okuda). After selection for the best model, the hazard ratio for survival comparing the patients with and without cytolysis after adjusting for age, pre-treatment AFP values, Okuda score and MELD score was 1.33 (0.45-3.90) Inhibitors,research,lifescience,medical (Table 4) . Figure 1 Kaplan-Meier curves of overall

survival according cytolysis occurrence in 157 patients after their first TACE treatment. The hazard ratio for the probability Inhibitors,research,lifescience,medical of death, adjusted for age, MELD, AFP and Okuda score was 1.33 in cytolysis versus noncytolysis … Table 4 Univariate and multivariate cox proportional hazard analysis of prognostic factors for mortality in 157 patients after TACE treatment Predictors of cytolysis Using a multivariate GEE model using the treatment as a unit of analysis (n=271), every increase in baseline AST values by one unit was associated with a decrease in the odds for cytolysis (OR 0.987; 0.975-0.999). Tumour size was not identified as an independent predictor for cytolysis within the same model (OR 1.136; Inhibitors,research,lifescience,medical 0.908-1.421). Discussion Originally, PCS was defined as the presence of fever, abdominal pain and vomiting Inhibitors,research,lifescience,medical during the first few days following TACE (23) and its incidence

varies from 40-85% (13). Tumour size was a predictive factor for its occurrence (24). An early study by Castells et al. associated the incidence of fever to tumour Drug_discovery necrosis and thus as an early marker of treatment response (11). Paye et al. redefined the post-chemoembolization selleck chemical Axitinib syndrome as the presence of cytolysis (elevation of liver transaminases) associated with fever. His study failed to reveal an association between chemoembolization fever or cytolysis and tumour necrosis. PCS was more often observed in fibrotic rather than cirrhotic livers. The authors during concluded that post-chemoembolization syndrome was a sign of normal hepatocyte destruction and not tumour necrosis (12). The association between fibrosis and cytolysis could have been confounded by tumour size as the tumours were significantly larger in the fibrotic compared to the cirrhotic livers. Using the same definition for post-chemoembolization syndrome, Wigmore et al.