Does Postembolization Fever after Chemoembolization Have Prognostic Significance for Survival in Patients with Unresectable Hepatocellular Carcinoma?

Purpose: To investigate risk factors and prognostic significance of postembolization fever (PEF)-a temperature of more than 38.0°C-after chemoembolization in patients with hepatocellular carcinoma (HCC). Materials and Methods: The authors retrospectively analyzed data from 442 patients with unresectable HCC who underwent their first session of chemoembolization without other procedure-related complications except postembolization syndrome between January 2005 and December 2006. Of the 442 patients, 362 (81.9%) were men and 80 (18.1%) were women; patients ranged in age from 28 to 86 years (median, 61 years). Results: PEF after chemoembolization developed in 91 patients (20.6%). Occurrence of PEF was closely associated with several clinical-laboratorial variables, although not with response to chemoembolization. With use of logistic regression analysis, however, a tumor size larger than 5 cm was the only independent factor related to PEF development (odds ratio, 8.192; 95% confidence interval [CI]: 3.641, 18.435; P < .001). Although PEF was not an independent predictor of progression-free survival, it significantly increased the risk of death by about 1.4-fold, in correlation with overall survival (hazard ratio, 1.378; 95% CI: 1.003, 1.893; P = .048). Conclusions: PEF after chemoembolization in patients with HCC was strongly correlated with large tumor size and was a significant independent predictor of overall survival.