Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 106276
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.106276
Analysis of risk factors for post-operative infection following drug-eluting trans arterial chemo embolization in hepatocellular carcinoma: A retrospective study
Gang Wang, Rui Qi
Gang Wang, Rui Qi, Department of Intervention, The First Hospital of Anhui University of Science and Technology, Huainan 232007, Anhui Province, China
Author contributions: Wang G was responsible for the conceptualization, data curation, formal analysis, investigation, methodology development, visualization, and drafting of the original manuscript; Qi R supervised the project, provided administrative and technical support, contributed to resource acquisition, validated the findings, and was responsible for manuscript review and editing; Qi R also secured funding and served as the corresponding author.
Institutional review board statement: This retrospective study was reviewed and approved by the Institutional Review Board of The First Hospital of Anhui University of Science and Technology (Approval No. 2022-LCSX033-001).
Informed consent statement: The requirement for informed consent was waived due to the retrospective nature of the study and anonymized patient data analysis.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this study.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Qi, MD, Department of Intervention, The First Hospital of Anhui University of Science and Technology, No. 203 Huabin Road, Tianjia'an District, Huainan 232007, Anhui Province, China. qirui19880901@126.com
Received: March 26, 2025
Revised: April 27, 2025
Accepted: May 15, 2025
Published online: June 27, 2025
Processing time: 65 Days and 3.1 Hours
Abstract
BACKGROUND

Post-operative infection is a common and serious complication following drug-eluting trans arterial chemo embolization (D-TACE) in patients with hepatocellular carcinoma (HCC), potentially compromising treatment efficacy and increasing morbidity.

AIM

To investigate the risk factors associated with post-operative infection in HCC patients undergoing D-TACE, and to provide evidence for clinical prevention and targeted intervention strategies.

METHODS

Clinical data of 77 primary HCC patients who underwent D-TACE in our hospital from January 2022 to December 2023 were retrospectively analyzed. Patient demographics, laboratory test results, tumor characteristics, and surgery-related parameters were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for post-operative infection.

RESULTS

Post-operative infection occurred in 20 cases (25.97%) among the 77 patients. Univariate analysis showed that age ≥ 65 years, Child-Pugh grade B, tumor diameter ≥ 5 cm, operation time ≥ 120 minutes, preoperative albumin < 35 g/L, and comorbid diabetes were significantly associated with post-operative infection (P < 0.05). Multivariate logistic regression analysis identified Child-Pugh grade B (OR = 2.851, 95%CI: 1.426-5.698), operation time ≥ 120 minutes (OR = 2.367, 95%CI: 1.238-4.523), and preoperative albumin < 35 g/L (OR = 2.156, 95%CI: 1.147-4.052) as independent risk factors for post-operative infection.

CONCLUSION

Liver function status, operation time, and preoperative albumin level are significant factors affecting post-operative infection in HCC patients undergoing D-TACE. For high-risk patients, enhanced perioperative management, appropriate timing of surgery, and active improvement of nutritional status should be implemented to reduce the risk of post-operative infection.

Keywords: Hepatocellular carcinoma; Drug-eluting trans arterial chemo embolization; Post-operative infection; Risk factors; Retrospective study

Core Tip: Liver function status (Child-Pugh grade B) and preoperative hypoalbuminemia (< 35 g/L) are critical risk factors for postoperative infection following drug-eluting trans arterial chemo embolization in hepatocellular carcinoma patients, with prolonged operation time (≥ 120 minutes) further increasing infection risk. High-risk patients may benefit from enhanced preoperative nutritional support, optimized timing of surgery, and strict perioperative monitoring. Larger tumor size and Bilobar involvement are associated with higher infection rates, though these effects are likely mediated through liver function and procedural complexity. Proactive management of comorbidities, particularly diabetes mellitus, is essential to reducing infection risk. Personalized preventive measures based on individual risk profiles can improve outcomes and reduce postoperative complications.