Transarterial chemoembolization and renal failure in hepatocellular carcinoma patients: Authors' reply

摘要

To the Editor: We appreciate the constructive comments by Dr Gianni-ni et al. (1) on our study addressing hepatocellular carcinoma (HCC) patients with ascites undergoing transarterial chemoembolization (TACE). Considering the increased risk of post-TACE liver decompensation in patients with a poor liver reserve [Child-Turcotte-Pugh (CTP) classification B or C], this subset of patients would be left with very few feasible treatment options according to current guidelines (2). Although some studies showed improved survival of HCC patients with advanced cirrhosis receiving TACE (3), discreet selection of HCC patients with CTP class B is highly recommended. In the study by Dr Giannini and colleagues, CTP score 7, lower serum bilirubin levels and absence of hepatic encephalopathy were identified as eligible criteria to select CTP class B HCC patients for TACE.