Fever after transcatheter arterial chemoembolization for hepatocellular carcinoma: Incidence and risk factor analysis

Objective. Post-treatment fever frequently occurs in hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE), but its incidence and clinical significance are unclear. The aim of this study was to identify the incidence and risk factors for fever after TACE in HCC patients. Material and methods. Forty-one consecutive HCC patients undergoing 73 sessions of TACE were included in the study. The incidence and possible risk factors associated with post-TACE fever were analyzed. Results. Forty-nine (67%) episodes of fever developed in 30 (73%) HCC patients after TACE, but none of the patients developed bacterial infection after TACE. Patients who developed fever were of younger age, had larger tumors, a higher dose of chemoembolization agents and a higher embolized volume compared with those without fever. Multivariate logistic regression disclosed that a dosage of doxorubicin plus iodized oil >23 during chemoembolization and tumor size >3 cm were significant predictors associated with the development of post-TACE fever (odds ratio: 3.749, 95% CI: 1.188-11.830, p=0.024 and odds ratio: 3.599, 95% CI: 1.107-11.706, p=0.033, respectively). Conclusions. Fever after TACE is common, but infectious complications are rare. Chemoembolization dosage and tumor size are predictive of fever after transcatheter arterial chemoembolization and may be of help in the prevention and care of this distressing complication.