Post-procedural pain is frequent after transarterial chemoembolization for hepatocellular carcinoma, and is only partially prevented by treatment selectivity.
Dr Maxime Ronot and colleagues from France determined the risk factors of severe pain after selective transarterial chemoembolization for hepatocellular carcinoma.
From 2012 to 2014, all treatment-naïve patients undergoing a first selective transarterial chemoembolization were included.
Risk factors for severe pain, that is, the need for opioid analgesics, were identified by uni- and multivariate analysis.
Internal validation of a logistic regression model for prediction of opioid intake was done with bootstrapping.
The research team analyzed 335 tumors in 159 patients, mean 63 years old.
|7% of patients requested opioids|
The researchers found that 17% of patients requested opioids.
The team noted that opioid intake was associated with young age, doxorubicin dose received, large hepatocellular carcinoma, absence of chronic liver disease, and alpha-fetoprotein levels.
On further analysis, the team found that opioid intake was associated with young age, absence of chronic liver disease, and a higher fraction of the doxorubicin dose.
The optimism-corrected area under the curve of the prediction model for opioid intake using these three factors was 0.751.
Dr Ronot's team concludes, "In patients with hepatocellular carcinoma treated with transarterial chemoembolization, selective procedure does not always prevent from severe pain."
"Young patients without chronic liver disease may be more susceptible to severe pain."