Safety and Feasibility of Outpatient Transcatheter Hepatic Arterial Embolization for Hepatocellular Carcinoma

Mitchell, Jason W.; O’Connell, W.; Kisza, P.; Klyde, David; Gonzalez, Sharon F.; Maldjian, Pierre D.; Bahramipour, Philip; Contractor, Sohail

doi:10.1016/j.jvir.2008.10.027

Cited by 13 publications

(3 citation statements)

References 29 publications

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“…7,10 Several previous studies addressed the safety of performing TACE on an outpatient basis. Mitchell et al 20 reported the safety of the outpatient concept in carefully selected patients, where 131 from 133 sessions were performed on outpatient cases and only 2 required readmission. Nasser et al 21 also reported the safety of treating the patients on outpatient basis.…”

Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

Current strategies in interventional oncology of colorectal liver metastases

Gruber‐Rouh

Marko

Thalhammer

et al. 2016

BJR

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The adequate treatment of non-resectable liver metastases from colorectal cancer which are resistant to systemic chemotherapy currently provides a great challenge. The aim is to identify and review key strategies in the treatment of colorectal liver metastases. A search for current literature on the topic of interventional strategies for colorectal metastases was performed in Medline in order to achieve this goal. Studies before 2005 and with ,20 patients treated for colorectal metastases were excluded. Transarterial chemoembolization (TACE), transarterial embolization and selective internal radiation therapy (SIRT) were identified as examples of regional strategies for colorectal liver metastases, utilizing the unique blood supply of the liver. Radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation were selected as examples for currently available ablative techniques. Median survival in the key studies reviewed ranged from 7.7 to 28.6 for TACE, 8.3-12.6 for SIRT, 8.2-53.2 for RFA and 29-43 months for MWA. After review of the literature, it can be concluded that interventional oncologic therapies are a safe and effective method for treating colorectal liver metastases. The use of new chemotherapeutic agents for local therapy and new ablation technologies and techniques may increase patient survival and allows a neoadjuvant therapy setting. In addition, a combination of local therapies may be used to increase effectiveness in the future, which is subject to further research. INTRODUCTIONColorectal cancer is one of the most common cancers that shows fatal progression.1 Colorectal carcinoma most commonly metastasises to the liver due to haematogenous spread.2 At the time of diagnosis, 20-30% of patients have liver metastases, and during the course of disease, up to 60% of patients develop hepatic metastases.3 Although surgical excision is the first-line treatment for colorectal metastases, only 10-25% of patients are candidates for surgical resection. 4 Neoadjuvant systemic chemotherapy only allows 10-30% of patients with unresectable colorectal liver metastases sufficient downsizing for resection.

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Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

Current strategies in interventional oncology of colorectal liver metastases

Gruber‐Rouh

Marko

Thalhammer

et al. 2016

BJR

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“…With the US health care expenditure outpacing the growth in the gross domestic product (11), it is critical for physicians to identify areas of opportunity for efficiency. A few previous studies (6,7,12) reported results regarding same-day discharge after TACE but had a narrow focus on establishing safety, and they lack analysis of patient characteristics, individual laboratory parameters, and procedural variables as predictors of recovery. The objective of this study was to use statistical tools to create and validate a comprehensive predictive model for PES in patients undergoing TACE for hepatocellular carcinoma.…”

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confidence: 99%

A Predictive Model for Postembolization Syndrome after Transarterial Hepatic Chemoembolization of Hepatocellular Carcinoma

et al. 2019

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To develop and validate a predictive model for postembolization syndrome (PES) following transarterial hepatic chemoembolization (TACE) for hepatocellular carcinoma. Materials and Methods: In this single-center, retrospective study, 370 patients underwent 513 TACE procedures between October 2014 and September 2016. Seventy percent of the patients were randomly assigned to a training data set and the remaining 30% were assigned to a testing data set. Variables included demographic, laboratory, clinical, and procedural details. PES was defined as pain and/or nausea beyond 6 hours after TACE that required intravenous medication for symptom control. The predictive model was developed by using conditional inference trees and Lasso regression. Results: Demographics, laboratory data, performance, tumor characteristics, and procedural details were statistically similar for the training and testing data sets. Overall, 83 of 370 patients (22.4%) after 107 of 513 TACE procedures (20.8%) met the predefined criteria. Factors identified at univariable analysis included large tumor burden (P = .004), drug-eluting embolic TACE (P = .03), doxorubicin dose (P = .003), history of PES (P , .001) and chronic pain (P , .001), of which history of PES, tumor burden, and drug-eluting embolic TACE were identified as the strongest predictors by the multivariable analysis and were used to develop the predictive model. When applied to the testing data set, the model demonstrated an area under the curve of 0.62, sensitivity of 79% (22 of 28), specificity of 44.2% (53 of 120), and a negative predictive value of 90% (53 of 59). Conclusion: The model identified history of postembolization syndrome, tumor burden, and drug-eluting embolic chemoembolization as predictors of protracted recovery because of postembolization syndrome.

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“…Early diagnosis of HCC allows for earlier treatment with favorable outcomes, which translates into reduced complications associated with HCC and hence decreased hospitalizations. As a bridge to transplant or as palliation in advanced stages of HCC, transarterial chemoembolization (TACE) can be performed and recent single-center studies suggest that these patients can safely be discharged home after the procedure without the need for overnight hospitalization [ 35 - 38 ]. Thus, there may have been a trend towards performing this procedure on an outpatient basis in the latter part of the study period, thereby leading to the significant decline in the HCC hospitalization rate observed in this study.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Outcomes of Hospitalizations Due to Hepatocellular Carcinoma

Mullangi¹,

Keesari²,

Zaher³

et al. 2021

Cureus

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BackgroundHepatocellular Carcinoma (HCC) is a severe complication of cirrhosis and the incidence of HCC has been increasing in the United States (US). We aim to describe the trends, characteristics, and outcomes of hospitalizations due to HCC across the last decade. MethodsWe derived a study cohort from the Nationwide Inpatient Sample (NIS) for the years 2008-2017. Adult hospitalizations due to HCC were identified using the International Classification of Diseases (9th/10th Editions) Clinical Modification diagnosis codes (ICD-9-CM/ICD-10-CM). Comorbidities were also identified by ICD-9/10-CM codes and Elixhauser Comorbidity Software (Agency for Healthcare Research and Quality, Rockville, Maryland, US). Our primary outcomes were in-hospital mortality and discharge to the facility. We then utilized the Cochran-Armitage trend test and multivariable survey logistic regression models to analyze the trends, outcomes, and predictors.

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Safety and Feasibility of Outpatient Transcatheter Hepatic Arterial Embolization for Hepatocellular Carcinoma

Cited by 13 publications

References 29 publications

Current strategies in interventional oncology of colorectal liver metastases

Current strategies in interventional oncology of colorectal liver metastases

A Predictive Model for Postembolization Syndrome after Transarterial Hepatic Chemoembolization of Hepatocellular Carcinoma

Epidemiology and Outcomes of Hospitalizations Due to Hepatocellular Carcinoma

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