Is transarterial chemoembolization beneficial for patients with diffuse infiltrative hepatocellular carcinoma?

Hung, Tsung–Hsing; Tsai, Chen–Chi; Lin, Chung-Chi; Lee, Hsing–Feng; Chu, Chi‐Jen; H, Lin

doi:10.1007/s12072-012-9392-1

Cited by 6 publications

(10 citation statements)

References 30 publications

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“…The performance of TACE for iHCC patients is rather controversial. Hung TH, et al reported that TACE was a preferred therapy for iHCC patients [9], while Lopez RR Jr. et al demonstrated no benefit of TACE for such patients [18]. In the present study, we evaluated the 1-month and 3-month tumor responses in patients with iHCC after undergoing DEB-TACE or cTACE, and the results showed that DEB-TACE might provide slightly better tumor response for patients with iHCC than cTACE.…”

Section: Discussionmentioning

confidence: 89%

“…Infiltrative HCC (iHCC) represents 7–15% of HCC cases and is often associated with hepatitis B infection, particularly in Asian countries [5, 6]. The prognosis of iHCC is poor, and the therapeutic modality is limited [7–9]. Due to the high propensity of portal vein involvement, patients with iHCC are not candidates for curative treatments, such as transplantation, hepatectomy, and local ablation [10, 11].…”

Section: Introductionmentioning

confidence: 99%

“…Due to the high propensity of portal vein involvement, patients with iHCC are not candidates for curative treatments, such as transplantation, hepatectomy, and local ablation [10, 11]. Palliative treatment, such as transarterial chemoembolization (TACE), is occasionally shown to be beneficial for such patients [8, 9, 12, 13]. However, patients presenting with iHCC often have associated severe liver cirrhosis and liver function deterioration [14], thus, the reservation of liver function during TACE is counted as one of the first priority.…”

Section: Introductionmentioning

confidence: 99%

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Conventional versus drug-eluting beads chemoembolization for infiltrative hepatocellular carcinoma: a comparison of efficacy and safety

Zhang

et al. 2019

BMC Cancer

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BackgroundTo compare the efficacy and safety between conventional transarterial chemoembolization (cTACE) and drug-eluting beads TACE (DEB-TACE) in patients with infiltrative hepatocellular carcinoma (iHCC).MethodsA total of 89 iHCC patients who were treated with either cTACE (n = 33) or DEB-TACE (n = 56) between April 2013 and September 2017 were included in this retrospective study. Patients with the situations that might have a poor outcome were defined as advanced disease including Child-Pugh class B, bilobar lesions, tumor size greater than 10 cm, ECOG 1–2, tumor burden of 50–70%, and the presence of ascites, arterioportal shunt (APS), and portal venous tumor thrombus (PVTT). The tumor response was measured 1-month and 3-month after the procedure. Progression-free survival (PFS) was calculated. Toxicity was graded by Common Terminology Criteria for Adverse Events v5.0 (CTCAE v5.0). The differences in tumor response, PFS, and toxicity were compared between the DEB-TACE group and cTACE group.ResultsAt 1-month and 3-month after the procedure, the objective response rate (ORR) in the overall study population was similar in DEB-TACE group and cTACE group. The disease control rate (DCR), at 1-month after the procedure, was significantly higher in the patients treated with DEB-TACE relative to those treated with cTACE (P = 0.034), while after 3 months, the difference did not differ between two groups. DEB-TACE showed a higher DCR than cTACE in patients with tumor size greater than 10 cm (P = 0.036) or associated with APS (P = 0.030) at 1-month after the procedure, while after 3 months, the difference was only noted in patients with APS (P = 0.036). The median PFS in DEB-TACE group was 96 days, while in cTACE group was 94 days, and there was no difference in PFS between two groups (P = 0.831). In the side effect analysis, abdominal pain (P = 0.034) and fever (P = 0.009) were more frequently present in the cTACE group than DEB-TACE group, but there was no difference in high grade liver toxicity between the two groups.ConclusionsCompared to cTACE, DEB-TACE offers slightly better DCR and tolerability for iHCC patients, particularly in patients associated with APS and large tumor size. However, DEB-TACE does not provide higher PFS than cTACE.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Conventional versus drug-eluting beads chemoembolization for infiltrative hepatocellular carcinoma: a comparison of efficacy and safety

Zhang

et al. 2019

BMC Cancer

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“…TACE only showed significant efficacy than supportive treatment in current iHCC studies. 7,25 The median OS time of iHCC patients treated with conventional TACE was 3-7months. 18,19,26,27 Due to the lack of consensus of the treatment suggestion for iHCC patients, we designed this study to compare the efficacy of hepatic resection and TACE in the specific HCC cohort.…”

Section: Discussionmentioning

confidence: 99%

Hepatic resection versus transarterial chemoembolization in infiltrative hepatocellular carcinoma: A multicenter study

Wang

Shen

Feng

et al. 2020

J of Gastro and Hepatol

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Background and Aim: Prognosis of infiltrative hepatocellular carcinoma (iHCC) is poor, and the treatments selection based on efficacy is unclear. We performed this multicenter study to compare the efficacy of hepatic resection and transarterial chemoembolization (TACE) in treating patients with iHCC. Methods: We retrospectively analyzed the overall survivals (OS) in 319 patients with iHCC who were initially treated by hepatic resection (n = 133) or TACE (n = 186) at four tertiary centers. Fifty-eight patients in the TACE group were assessed as resectable and compared with the hepatic resection group in subgroup analysis. A propensity score matched (PSM) analysis was performed to reduce selection bias. Cox regression was performed to identify significant factors associated with OS. Results: The median OS time was significantly longer in the hepatic resection group than that in the TACE group, before and after PSM (before PSM, 17.5 vs 7.3 months, P < 0.0001; after PSM, 14.0 vs 7.3 months, P < 0.0001). The multivariable analysis indicated TACE as a risk factor of OS (hazard ratio = 2.233, 95% confidence interval = 1.492 to 3.341, P < 0.0001), as well as portal venous tumor thrombosis grades 3-4 and alpha fetal protein (AFP) > 400 ng/mL. In the subgroup analysis, the better efficacy of hepatic resection over TACE persisted regardless of the grade of portal venous tumor thrombosis and the level of AFP. As for resectable patients, hepatic resection still showed significant survival benefit (before PSM, 17.5 vs 11.2 months, P = 0.0013; after PSM, 14.0 vs 10.9 months, P = 0.0304). Conclusion: Hepatic resection might be the better choice for patients with iHCC due to its better survival benefit than TACE.

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“…GGT was utilized as a diagnostic tumor biomarker for liver disease with a high sensitivity of 83-100%, but it only has a low specificity of 32% (10). Therefore, long since GGT was not utilized as an (29,(36)(37)(38)(39)(40). The combination of GGT and other indicators, such as tumor size, tumor number, MVI, or laboratory data for AFP and DCP, should be paid more attention when deciding a treatment and predicting the curative results for patients with HCC (41).…”

Section: Ggt As a Predictive Biomarker In Clinical Investigationsmentioning

confidence: 99%

Advances of diagnostic and mechanistic studies of γ-glutamyl transpeptidase in hepatocellular carcinoma

Xia

Song

Sun

et al. 2016

DD&T

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Is transarterial chemoembolization beneficial for patients with diffuse infiltrative hepatocellular carcinoma?

Abstract: TACE is a preferred therapy for D-HCC patients.

Cited by 6 publications

References 30 publications

Conventional versus drug-eluting beads chemoembolization for infiltrative hepatocellular carcinoma: a comparison of efficacy and safety

Conventional versus drug-eluting beads chemoembolization for infiltrative hepatocellular carcinoma: a comparison of efficacy and safety

Hepatic resection versus transarterial chemoembolization in infiltrative hepatocellular carcinoma: A multicenter study

Advances of diagnostic and mechanistic studies of γ-glutamyl transpeptidase in hepatocellular carcinoma

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