Unfortunately, many patients present with an advanced disease not amenable to surgical therapy. For these patients, locoregional therapies are the next best option. Transarterial chemoembolization (TACE) FDA approved Drug Library involves the delivery of a chemotherapeutic agent to the tumour via the hepatic artery. It is used in the treatment of large unresectable tumour (5,6), but also as a bridge therapy before liver transplantation (7) and to downstage a

tumour to a size that is convenient for surgical management (8,9). The Inhibitors,research,lifescience,medical post-chemoembolization syndrome (PCS), characterized by the elevation of blood transaminases accompanying right upper quadrant pain, nausea and fever is often observed after TACE. It manifests itself in the first few days after

the treatment with a return to baseline transaminases levels after one week. The exact nature of liver cytolysis is controversial and while some have argued that it indicates tumour necrosis (10,11); for other it represents normal hepatocyte injury and a deleterious event (12,13). As most TACE protocols Inhibitors,research,lifescience,medical include a variety of analgesics, anti-inflammatory, Inhibitors,research,lifescience,medical anti-pyretic and anti-emetic agents that mask the symptoms associated with PCS, liver cytolysis is an objective sign of the syndrome’s occurrence. At this moment, little is known on the short term impact of cytolysis occurring after TACE for hepatocellular cancer. In one study, neither Inhibitors,research,lifescience,medical post-chemoembolization syndrome nor cytolysis was associated with an improved tumour response 8 weeks after treatment (13). However, only half of the patients in the study had a diagnosis of hepatocellular cancer and cirrhosis was only present in forty percent. In the present study, we investigate if the occurrence of cytolysis is associated with favourable radiological response in patients with hepatocellular carcinoma. Also, we will evaluate

if the occurrence Inhibitors,research,lifescience,medical of cytolysis increases the risk of hepatic decompensation. Finally, we will look at the impact of cytolysis on overall survival after TACE. Patients and methods Data source The study was conducted at the CHUM-Hôpital St-Luc (Montréal, Canada), a tertiary care center for hepatic diseases. The study was approved by our institutional Rutecarpine board and the data was collected from the medical archives. Patients having received a chemoembolization treatment were identified using the Canadian Classification of Health Interventions (CCI) code 1.KE.51.GQ-M0 and the Canadian Classification of Diagnostic, Therapeutic and Surgical Procedures (CCP) code 62.93. All charts identified were reviewed to verify that HCC was the underlying diagnosis. Data collected included demographics, underlying liver disorder, radiological evaluation of the tumor, chemoembolization protocol and laboratory tests. The date of death was obtained from the medical record.