Is the Y90-radioembolization treatment effective on the intermediate-advanced stage of hepatocellular carcinoma and what is the albumin-bilirubin score's prediction factor for survival?

Postoperative SIRS after thermal ablation of HCC: Risk factors and short-term prognosis

Background

We aimed to explore the potential risk factors and short-term prognosis for SIRS after thermal ablation of hepatocellular carcinoma (HCC).

Methods

Data from patients with HCC who underwent thermal ablation in the Third Affiliated Hospital of Sun Yat-sen University between January 2015 and August 2021 were retrieved from the perioperative database. Pre-, intra- and postoperative data between SIRS group and non-SIRS group were compared and multivariate logistic regression analysis was performed to identify the risk factors for SIRS after thermal ablation.

Results

A total of 1491 patients were enrolled and 234 (15.7 %) patients developed SIRS after thermal ablation. Compared with those without SIRS, patients with SIRS had a longer hospital stay, higher hospitalization costs and higher risk of more severe postoperative complications. In the multivariate logistic regression analysis, current smoking (OR 1.58, 95 %CI 1.09-2.29), decreased HCT (OR 1.51,95 %CI 1.11-2.04), NEUT < 1.5 × 109/L(OR 1.74, 95 %CI 1.14-2.65), NEUT% < 0.5 or > 0.7 (OR 1.36, 95 %CI 1.01-1.83) and PT > 16.3s (OR 2.42, 95 %CI 1.57-3.74) were significantly associated with postoperative SIRS.

Conclusions

Current smoking, decreased HCT, neutropenia, abnormal percentage of neutrophils and prolonged PT are the independent risk factors for SIRS after thermal ablation of HCC, which worsens outcomes of patients. This study can help identify high-risk population and guide appropriate care so as to reduce the incidence of postoperative SIRS.