Interleukin-8 level as a prognostic marker in patients with hepatitis B virus-associated hepatocellular carcinoma treated with transarterial chemoembolization

• The study measured pretreatment levels of 11 cytokines including IL-8.
• TACE refractoriness and LT-free survival were evaluated in 119 patients with HCC.
• Combined AFP and IL-8 levels independently predicted overall TACE refractoriness.
• High IL-8 level was also associated with poor LT-free survival.
• Serum IL-8 level is a useful prognostic marker in TACE-treated patients with HCC.

We investigated the association between serum interleukin (IL)-8 levels and post-transarterial chemoembolization (TACE) outcomes in patients with hepatitis B virus (HBV)-associated HCC. We enrolled 119 TACE-treated patients with HBV-associated HCC; TACE refractoriness and liver transplantation (LT)-free survival were evaluated during follow-up. Pre-TACE serum levels of various cytokines (epidermal growth factor [EGF], fibroblast growth factor 2, granulocyte-colony stimulating factor [G-CSF], interferon-γ, IL-8, IL-12, IL-17A, interferon-γ-inducible protein-10, monocyte chemotactic protein-1, tumor necrosis factor-α and vascular endothelial growth factor) were analyzed. During a mean follow-up of 24.3 (1–79) months, 91 patients (76.5%) exhibited TACE refractoriness. In multivariate analyses, multiple tumors (hazard ratio [HR], 2.37; 95% confidence interval [CI], 1.28–4.39; P = 0.006), large tumor size (HR, 2.36; 95% CI, 1.38–4.03; P = 0.002), and combination of alpha-fetoprotein and IL-8 levels (AFP > 400 ng/mL or IL-8 > 32 pg/mL; HR, 1.72; 95% CI, 1.03–2.85; P = 0.037) independently predicted overall TACE refractoriness. Higher EGF (>35 pg/mL) and lower G-CSF levels (⩽12.5 pg/mL) were associated with early TACE refractoriness (<1 year; HR, 3.47; 95% CI, 1.01–11.96; P = 0.049 and HR, 6.25; 95% CI, 1.62–23.81; P = 0.008, respectively). Furthermore, high IL-8 level (>32 pg/mL; HR, 1.68; 95% CI, 1.09–2.59; P = 0.020) was associated with poor LT-free survival. In conclusion, pretreatment serum IL-8 is a useful prognostic marker for TACE refractoriness and LT-free survival in TACE-treated patients with HBV-associated HCC.