CIRSE Standards of Practice on Hepatic Transarterial Chemoembolisation

Lucatelli, Pierleone; Burrel, Marta; Guiu, Boris; Rubeis, Gianluca De; Delden, Otto van; Helmberger, Thomas

doi:10.1007/s00270-021-02968-1

Cited by 56 publications

(52 citation statements)

References 157 publications

(219 reference statements)

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“…One very frequently encountered complication after ablation of ICC is the development of a biliary abscess, with an incidence rate ranging between 7% and 20% [63] . Risk factors for the occurrence of this complication are cholangiectasis (since thermal injury to the bile duct leads to contamination of ablation zone by enteric bacteria) and presence of bilioenteric anastomosis (due to retrograde enteric bacterial contamination of the biliary tract).…”

Section: Ablationmentioning

confidence: 99%

Radiological imaging and non-surgical local treatments for cholangiocarcinoma

Corte¹,

Gaeta²,

Steidler³

et al. 2022

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Cholangiocarcinoma (CC) is a malignancy with a very heterogeneous spectrum of morphopathological and prognostic characteristics. Diagnostic imaging is fundamental for early detection, preoperative staging, and resectability assessment, as well as early recognition of prognostic factors. Radical surgical treatment is limited by disease stage and technical feasibility. Interventional radiology has acquired a critical function in addressing disease control and survival improvement through loco-regional therapies, specifically in the setting of intrahepatic CC. In this review, we will describe the current state of art of diagnostic imaging, focusing on intrahepatic CC and proximal extrahepatic CC, and delineate the available loco-regional therapies strategies for unresectable intrahepatic CC.

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Section: Ablationmentioning

confidence: 99%

Radiological imaging and non-surgical local treatments for cholangiocarcinoma

Corte¹,

Gaeta²,

Steidler³

et al. 2022

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“…According to BCLC guidelines, transarterial chemoembolization (TACE) and transarterial embolization (TAE) are recommended for intermediate-stage HCC patients to locally control the disease and provide palliative care [1,9]. About 70% of HCC patients at the time of diagnosis have intermediate-to-advanced stage disease, when curative-intent treatment modalities are no longer possible [9,106].…”

Section: Precision Medicine and Loco-regional Proceduresmentioning

confidence: 99%

Precision Medicine for Hepatocellular Carcinoma: Clinical Perspective

Galun

Mijač

Filipović

et al. 2022

JPM

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Hepatocellular carcinoma (HCC) is one of the major malignant diseases worldwide, characterized by growing incidence and high mortality rates despite apparent improvements in surveillance programs, diagnostic and treatment procedures, molecular therapies, and numerous research initiatives. Most HCCs occur in patients with liver cirrhosis, and the competing mortality risks from the tumor and the cirrhosis should be considered. Presently, previously identified risk factors, such as hepatitis virus infection, hepatic inflammation and fibrosis, and metabolic syndrome, may be used as chemoprevention targets. The application of precision medicine for HCC management challenges the one-size-fits-all concept; moreover, patients should no longer be treated entirely according to the histology of their tumor but based on molecular targets specific to their tumor biology. Next-generation sequencing emphasizes HCC molecular heterogeneity and aids our comprehension of possible vulnerabilities that can be exploited. Moreover, genetic sequencing as part of a precision medicine concept may work as a promising tool for postoperative cancer monitoring. The use of genetic and epigenetic markers to identify therapeutic vulnerability could change the diagnosis and treatment of HCC, which so far was based on Barcelona clinic liver cancer (BCLC) staging. In daily clinical practice, the shift from a stage-oriented to a therapeutic-oriented approach is needed to direct the choice of HCC treatment toward the potentially most effective option on an individual basis. The important factor in precision medicine is the promotion of patient management based on the individual approach, knowing that the final decision must be approved by a multidisciplinary expert team.

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“…Transarterial therapies can be used to reduce the burden of tumor within the transplant criteria (downstaging), to control the growth of tumor in patients who are currently on the transplant waiting list (bridging), and to increase the survival of patients who are not eligible to undergo a transplant (palliative). A multidisciplinary tumor board consisting of oncologists, surgeons, diagnostic and interventional radiologists, and hepatologists optimally can decide in aggregate if transarterial therapy is indicated for each individual patient [ 46 ]. Figure 2 shows the BCLC-approach indications for transarterial therapies in HCC [ 5 ].…”

Section: Indications and Patient Selection For Treatment With Transar...mentioning

confidence: 99%

“…The following tests are recommended for diagnosing the extent of liver function and obtaining baseline liver function for potential postprocedural hepatotoxicity [ 46 ]: Aminotransferase, Cholinesterase, Alkaline phosphatase, Gamma-glutamyl transferase, Bilirubin, Albumin, Prothrombin time, Creatinine, Electrolytes. …”

Section: Patient Preparationmentioning

confidence: 99%

“…Intravenous fluids should be considered in those without cardiac contraindications. Anxiolytics have also been found to be beneficial pre-procedure [ 46 ]. If predisposing factors for liver abscess listed below are found, then an antimicrobial regimen such as 400 mg of moxifloxacin by mouth daily, beginning three days pre-procedure to seventeen days post-embolization, should be prescribed; however, longer courses are also utilized [ 86 ].…”

Section: Patient Preparationmentioning

confidence: 99%

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Intraarterial Therapies for the Management of Hepatocellular Carcinoma

Garg

Shrigiriwar

Habibollahi

et al. 2022

Cancers

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Image-guided locoregional therapies play a crucial role in the management of patients with hepatocellular carcinoma (HCC). Transarterial therapies consist of a group of catheter-based treatments where embolic agents are delivered directly into the tumor via their supplying arteries. Some of the transarterial therapies available include bland embolization (TAE), transarterial chemoembolization (TACE), drug-eluting beads–transarterial chemoembolization (DEBs–TACE), selective internal radioembolization therapy (SIRT), and hepatic artery infusion (HAI). This article provides a review of pre-procedural, intra-procedural, and post-procedural aspects of each therapy, along with a review of the literature. Newer embolotherapy options and future directions are also briefly discussed.

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CIRSE Standards of Practice on Hepatic Transarterial Chemoembolisation

Cited by 56 publications

References 157 publications

Radiological imaging and non-surgical local treatments for cholangiocarcinoma

Radiological imaging and non-surgical local treatments for cholangiocarcinoma

Precision Medicine for Hepatocellular Carcinoma: Clinical Perspective

Intraarterial Therapies for the Management of Hepatocellular Carcinoma

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