{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:17:12Z","timestamp":1776356232927,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T00:00:00Z","timestamp":1730505600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate the predictors of deterioration of the Child\u2010Pugh classification 1\u2009month after transcatheter arterial chemo\u2010embolization (TACE) in patients with treatment\u2010naive hepatocellular carcinoma (HCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2010 and 2020, consecutive patients who underwent conventional TACE using epirubicin as the initial treatment were enrolled. Patients with Barcelona Clinic Liver Cancer stage\u20100, A or B and Child\u2010Pugh class A were included. The Child\u2010Pugh score was evaluated before treatment and 1\u2009month after TACE. The following variables were analyzed by univariate and multivariate analyses as predictors of deterioration of the Child\u2010Pugh class from A to B: age, sex, etiology, serum albumin, bilirubin, prothrombin time (PT), encephalopathy, ascites, largest tumor diameter, tumor number, tumor location, \u03b1\u2010fetoprotein, protein induced by vitamin K absence or antagonist\u2010II, epirubicin dosage, ethiodized oil dosage, and number of treated liver segments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 152 patients were retrospectively enrolled. The deterioration rate of the Child\u2010Pugh class from A to B was 8.6%. Multivariable analysis showed that serum albumin\u2009\u2264\u20093.8\u2009g\/dL, PT\u2009\u2264\u200980%, and largest tumor diameter\u2009\u2265\u20093.8\u2009cm were predictors of deterioration of the Child\u2010Pugh class. The deterioration rate to Child\u2010Pugh class B was 0% in patients with up to one of these factors, 14.3% in those with two factors, and 70% in those with three factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A combination of serum albumin\u2009\u2264\u20093.8\u2009g\/dL, PT\u2009\u2264\u200980%, and largest tumor diameter\u2009\u2265\u20093.8\u2009cm can predict the immediate deterioration of the Child\u2010Pugh classification from A to B following TACE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.70367","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T05:08:19Z","timestamp":1730524099000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of Immediate Deterioration of the Child\u2010Pugh Classification From A to B After Transcatheter Arterial Chemo\u2010Embolization for Treatment\u2010Naive Hepatocellular Carcinoma"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6360-4926","authenticated-orcid":false,"given":"Kazuo","family":"Asano","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Graduate School of Medicine Osaka City University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Kageyama","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-4790","authenticated-orcid":false,"given":"Atsushi","family":"Jogo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2738-8781","authenticated-orcid":false,"given":"Kazuki","family":"Murai","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshimi","family":"Yukawa\u2010Muto","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoshi","family":"Odagiri","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Kotani","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Graduate School of Medicine Osaka Metropolitan University  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritsuzo","family":"Kozuka","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Graduate School of Medicine Osaka Metropolitan University  Osaka 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