Patrick Nicholson MBBCh, Presenter: Nothing to Disclose

Kevin Murphy MBBCh, MRCS, Abstract Co-Author: Nothing to Disclose

Karl James MBBCh, MRCS, Abstract Co-Author: Nothing to Disclose

Jennifer Murphy MBBCh, MRCPI, Abstract Co-Author: Nothing to Disclose

David James Tuite MBBCh, Abstract Co-Author: Nothing to Disclose

Owen J. O'Connor MBBCh, Abstract Co-Author: Nothing to Disclose

Adrian Paul Brady FFR(RCSI), FRCR, Abstract Co-Author: Nothing to Disclose

Peter Mark MacEneaney MBBCh, Abstract Co-Author: Nothing to Disclose

The prognostic value of C-reactive protein (CRP) in patients with hepatocellular carcinoma (HCC) is well established, but there exists relatively little data in its use in HCC patients undergoing transarterial chemoembolization (TACE).  We sought to look at outcomes in our institutions in patients who underwent TACE for HCC. We further sought to evaluate the value of pre-embolization CRP levels in predicting clinical and radiological outcomes following TACE. 

This multi-center study involved a retrospective review of 34 patients (73±7.9 years, 29 male) who underwent a total of 100 TACE procedures over a six-year period. Pre-procedure CRP values were available in 90% of cases.  Other factors evaluated included liver function tests and tumour markers (Bilirubin, Alkaline Phosphatase, transaminases (AST/ALT), gamma glutamyl transpeptidase (GGT), and alpha-fetoprotein). Following TACE, we evaluated both clinical factors (overall survival) and radiological response to TACE (as measured by modified RECIST criteria (mRECIST) on follow-up CT at 3 months).  SPSS was used to analyze the results via T-Test, Mann-Whitney test, Pearson correlation, Spearman correlation and Kaplan-Meier analysis

Follow-up imaging was available in 85% of patients. Median follow-up was 28 months (range 1-76). No association was found between CRP and liver function tests, tumour markers, patient age or other biochemical parameters (r<0.3 for all comparisons). An abnormal pre-procedure CRP was found to be independently and significantly associated with both disease response (on a per procedure basis on follow up imaging, p<0.001) and overall patient survival. A CRP >20mg/l before first TACE treatment carried the worst prognosis (mean survival 9.25 Vs 17.76 months, p=0.007). 

Serum CRP measurement can be used to predict response to TACE in patients with HCC.

CRP is a cheap and widely-available test which can be used as a pre-procedural predictor of response to TACE in patients which HCC. It can be used to help risk-stratify those patients who would benefit from TACE. 

Nicholson, P, Murphy, K, James, K, Murphy, J, Tuite, D, O'Connor, O, Brady, A, MacEneaney, P, CRP as a Predictor of Response to TACE in HCC.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018752.html