{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:28:52Z","timestamp":1787776132907,"version":"build-2784847793"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study aimed to identify the predictors of liver decompensation and mortality in patients with HCC treated with trans arterial radioembolization (TARE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis of 140 HCC patients who underwent TARE was conducted. Kaplan\u2010Meier and multivariate Cox regression analyses were performed to identify the key predictors of mortality and liver decompensation, defined as a total bilirubin level greater than 50 \u03bcmol\/l or an upgrade in the Child\u2010Pugh class within three months of the first TARE procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The cohort comprised 69.3% males with a mean age of 71.3 \u00b1 11.9 years. Most patients (73.6%) had Child-Pugh class A cirrhosis and 34.3% had BCLC stage B disease. Liver decompensation was recorded in 55 patients (39.2%) within three months of the first TARE procedure. A total of 80 patients (57.1%) died during the follow-up period. The median survival was significantly longer in those without liver decompensation (3.2 vs. 0.7 years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Multivariate analysis revealed that male gender (adjusted odds ratio [aOR] 5.889,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.009), cirrhosis (aOR 6.82,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.047), and baseline international normalized ratio (INR) (aOR 316.664,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.013) were independent predictors of liver decompensation. Cox regression analysis revealed several significant predictors of increased mortality including ascites (HR 2.012, 95% CI, 1.122\u20133.61;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.019), portal vein invasion (HR 1.695, 95% CI, 1.057\u20132.718;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.029), and diabetes mellitus (HR 1.823, 95% CI, 1.017\u20133.265;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.044). Conversely, non-multifocal HCC (HR 0.593, 95% CI, 0.369\u20130.955;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.031), treatment of the liver lobe other than the right lobe (HR, 0.482; 95% CI 0.236\u20130.986,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.046), and age \u226560 years (HR 0.288, 95% CI, 0.139\u20130.597;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) were associated with a reduced risk of mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study identified the key predictors of liver decompensation and mortality in patients with HCC undergoing TARE, potentially improving patient selection and management strategies.<\/jats:p>\n                  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