Changes in liver and spleen stiffness after transarterial chemoembolization for hepatocellular carcinoma and role in predicting hepatic decompensation

Table 1 Baseline characteristics of hepatocellular carcinoma patients undergoing transarterial chemoembolization, mean ± SD/n (%)

Characteristics	n = 102
Age (years)	63.8 ± 10.1
Males	86 (84.3)
Body mass index (kg/m2)	24.1 ± 4.2
Etiology
Hepatitis B virus infection	41 (40.2)
Hepatitis C virus infection	25 (24.5)
MASLD	9 (8.8)
Alcohol-related liver disease	17 (16.7)
BCLC stage
A	32 (31.4)
B	62 (60.7)
C	8 (7.8)
Previous treatment
No previous treatment	47 (46.1)
Locoregional treatment	50 (49.0)
Systemic therapy	1 (1.0)
Liver resection or lobectomy	4 (3.9)
Tumor characteristics
Tumor size (largest diameter)
< 5 cm in size	71 (69.6)
5-8 cm in size	16 (15.7)
> 8 cm in size	15 (14.7)
Unilobar	69 (67.6)
Bilobar	33 (32.4)
Single nodule	33 (32.4)
Multiple nodules	69 (67.6)
Non-selective beta-blocker use	25 (24.5)
Spleen diameter (cm)	10.9 ± 2.8
Platelet count (μL)	153922 ± 91509
Alpha-fetoprotein (IU/mL)	4046 ± 19144
Portal vein thrombosis	22 (21.6)
mALBI grade
Grade 1	39 (38.2)
Grade 2a	30 (29.4)
Grade 2b	26 (25.5)
Grade 3	7 (6.9)
MELD score	9.2 ± 3.0
Child-Pugh class
A	87 (85.3)
B	15 (14.7)

BCLC: Barcelona Clinic Liver Cancer; mALBI: Modified albumin-bilirubin; MASLD: Metabolic dysfunction-associated steatotic liver disease; MELD: Model for end-stage liver disease.

Table 2 Predictors of hepatic decompensation in hepatocellular carcinoma patients after transarterial chemoembolization

Variables	Univariate analysis		Multivariate analysis model 1		Multivariate analysis model 2		Multivariate analysis model 3
	OR (95%CI)	P value	aOR (95%CI)	P value	aOR (95%CI)	P value	aOR (95%CI)	P value
Age, years	1.01 (0.96-1.06)	0.699
Female (%)	3.37 (1.04-10.87)	0.042
Body mass index (kg/m2)	0.97 (0.86-1.09)	0.582
Etiology (%)
Hepatitis B virus infection	Reference
Hepatitis C virus infection	4.05 (1.17-14.02)	0.027
MASLD	0.90 (0.09-8.80)	0.928
Alcohol	0.96 (0.17-5.51)	0.963
Cryptogenic	2.06 (0.33-12.81)	0.439
Others	0 (0)	1
BCLC stage (%)
A	Reference
B	2.82 (0.75-10.65)	0.126
C	3.22 (0.44-23.65)	0.250
Previous treatment (%)
No previous treatment	Reference
Locoregional treatment	0.80 (0.28-2.30)	0.684
Systemic therapy	0 (0)	1.000
Liver resection	1.41 (0.13-15.16)	0.778
Number of TACE	1.13 (0.84-1.51)	0.418
Tumor size (cm)	1.05 (0.92-1.18)	0.489
Beta-blocker use (%)	3.77 (1.31-10.8)	0.014
Splenic length (mm)	1.03 (1.01-1.05)	0.006
Platelet count (μL)	1.00 (1.00-1.00)	0.084
Alpha-fetoprotein (IU/mL)	1.00 (1.00-1.00)	0.295
Portal vein thrombosis (%)	1.93 (0.64-5.87)	0.245
MELD score	1.08 (0.94-1.25)	0.290
mALBI grade ≥ 2B	6.83 (2.29-20.31)	< 0.001	7.05 (1.92-25.94)	0.003
Child-Pugh score	2.02 (1.20-3.41)	0.008			2.24 (1.20-4.19)	0.011
Child-Pugh grade
A	Reference						Reference
B	3.79 (1.16-12.47)	0.028					4.73 (1.10-20.38)	0.037
SSM by 2D-SWE above 54 kPa	16.07 (4.92-52.48)	< 0.001	16.52 (4.39-62.19)	< 0.001	18.59 (5.11-67.66)	< 0.001	17.71 (5.04-62.19)	< 0.001
LSM by 2D-SWE above 42 kPa	4.44 (1.52-12.91)	0.006

aOR: Adjusted odds ratio; OR: Odds ratio; CI: Confidence interval; BCLC: Barcelona Clinic Liver Cancer; MASLD: Metabolic dysfunction-associated steatotic liver disease; MELD: Model for end-stage liver disease; kPa: Kilopascals; TACE: Transarterial chemoembolization; mALBI: Modified albumin-bilirubin; 2D-SWE: Two-dimensional shear wave elastography; LSM: Liver stiffness measurement; SSM: Spleen stiffness measurement.