P44 Clinical outcomes, safety and length of stay for patients receiving transarterial chemoembolisation (TACE): a retrospective audit

<h3>Introduction</h3> Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer, 90% of cases are associated with chronic liver disease. Early detection and management of HCC remain challenging due to the lack of specific symptoms. Despite wide spread surveillance programmes for at risk patients, the majority patients present beyond the stage where curative treatments are an option. Transarterial chemo-embolisation (TACE) is a commonly used treatment for HCC treatment. It is principally a palliative treatment used in locally advanced disease (BCLC stage B), but can be used to down stage patients to allow curative options. This audit looks at whether factors such as the patient demographic, characteristic of the tumor, Child Pugh score and Model of end-stage liver disease (MELD) affect the length of stay of patients post TACE, and their clinical outcomes. <h3>Method</h3> This retrospective audit analysed data from patients across NHS Greater Glasgow and Clyde who received TACE between August 2022 – September 2023. Patients were identified and their medical records accessed to obtain information on; date of diagnosis, number/size of tumor(s), number of TACE sessions, MELD and Child-Pugh score. We reviewed the most recent TACE session within this window and any associated complications. Data was analysed to assess the correlation between these factors and the length of stay of each patient, and clinical outcomes based on follow up imaging at 4–6 weeks. <h3>Results</h3> 42 patients were identified (figure 1). The median length of hospital stay post-TACE was 1.5 days (Range 1–14 days). Only 2 patients (4.8%) experienced significant complications post TACE (1 acute cholecystitis, 1 liver infarction and abscess formation). Follow-up imaging at 4- 6 weeks, demonstrated 14 patients (33%) achieved disease control, 18 (43%) had viable tumour amenable to further TACE, with 10 (24%) had disease progression. There was no correlation between the number and size lesions treated or the number of previous treatments, and length of stay. <h3>Conclusion</h3> This audit demonstrates that in the majority of patients TACE can be delivered with an overnight hospital stay, with low risk of significant adverse events. Disease progression was prevented in 76% of patients, with no viable tumour seen on follow up imaging in 33% of patients. No correlation was found between tumor characteristics or patient demographics and length of hospital stay or complication rates.