Long-term result of transcatheter arterial embolization for liver hemangioma

Abstract

Transcatheter arterial embolization (TAE) is a method for the treatment of liver hemangioma, but fewer studies reported the long-term result.Retrospective study was conducted to liver hemangioma patients who received TAE. The inclusion criteria included the following: the period of follow-up was more than 5 years; and patients were followed up for less than 5 years, but received surgical treatment due to the enlargement of tumor or severe complications of TAE. The collected data included sex, age, size of the tumor, times of TAE, complications, period of follow-up, long-term result, and whether or not surgery was finally performed.Fifty-five patients were included, and the average age was 43.1 ± 8.6 years. The average size of liver hemangioma was 9.0 ± 4.3 cm. Four patients (7.3%) had severe complications after TAE, including 2 cases of biloma which were cured by surgery. The tumor size was smaller or the same in 19 patients after 5 years follow-up, and the long-term effective rate was 35.8%. The size of tumor became larger in the other 34 patients (64.2%), and 29 patients (54.7%) received surgery finally. The long-term effective rate for patients with ≥10 cm tumor and <10 cm tumor were 12.5% and 45.9%, respectively, and the difference was significant (P = .019).The long-term result of TAE for liver hemangioma was not satisfying, and the treatment had the risk of severe complication. For patients with asymptomatic liver hemangioma, TAE should not be conducted.

Transarterial (Chemo-)Embolization and Lipiodolization for Hepatic Haemangioma

“…The indication for treatment was clearly stated for 231/1284 patients (18.0%) [ 8 , 16 , 38 , 41 – 43 , 45 , 48 – 50 , 53 ]. The main treatment indication was tumour size (104/231 patients; 45.0%).…”

“…Biopsy was occasionally used in case of unsure diagnosis or if the study was conducted before widespread availability of CT and MRI [ 16 , 31 , 38 , 48 , 51 ]. Lipiodolization was performed with either pingyangmycin or bleomycin [ 8 , 31 , 38 , 45 , 47 , 50 , 52 – 54 ]. TAE/TACE procedures usually included the use of gelfoam [ 41 , 43 , 44 , 46 , 48 , 49 ].…”

“…TAE/TACE procedures usually included the use of gelfoam [ 41 , 43 , 44 , 46 , 48 , 49 ]. Use of prophylactic antibiotic therapy was reported in six studies [ 8 , 38 , 48 , 49 , 53 , 54 ]; supportive treatment, usually analgesia and antiemetics, was used in twelve studies [ 8 , 31 , 38 , 41 , 43 , 45 , 48 – 51 , 53 , 54 ]. One study used glutathione for reasons not mentioned by the authors [ 31 ].…”

“…Multiple embolization/lipiodolization procedures were performed [ 8 , 31 , 38 , 44 , 45 , 48 , 53 , 54 ] for different reasons in each study, but especially in patients with large tumours [ 8 , 31 , 38 , 44 , 53 ]. Failure of embolization/lipiodolization occurred in 4/1244 patients (0.3%) [ 48 , 52 ].…”

“…Data from 1223/1284 (95.2%) patients in fifteen studies were reported following the RECIST guidelines; tumour size was reduced in 1100 patients (89.9%), stable in 89 patients (7.3%). Growth of tumour was reported in 34 patients (2.8%), all in one study [ 45 ]. The change in tumour size was measured after a weighted average of 8.6 months.…”