Effect of silymarin on hepatic function of patients with unresectable hepatocellular carcinoma after transcatheter hepatic arterial chemoembolization

Transcatheter hepatic arterial chemoembolization (TACE) is common treatment for unresectable hepatocellular carcinoma. Silymarin, derived from milk thistle, is widely used internationally for chronic liver disease. Some Taiwanese physicians prescribe silymarin as a hepatoprotective agent after TACE, although there is no evidence on its efficacy in this setting. Retrospectively compare two groups of patient undergoing TACE at our institution: 111 given silymarin postoperatively and 133 who underwent the same procedure and received similar postoperative care but were not given silymarin. The postoperative liver function was evaluated. Patients prescribed silymarin took 280 mg orally daily for two weeks. Liver function tests were checked at baseline and on post-TACE days 2, 4, and 6 and weeks 2-5. Groups were comparable for age, gender, and Child-Pugh class. There were no significant differences between the two groups at different time points in serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, albumin and lactate dehydrogenase. Oral silymarin did not accelerate recovery of hepatic function following TACE; there is no basis for its use in this setting.