Study of severe and rare complications of transarterial chemoembolization (TACE) for liver cancer

Xia, Jinglin; Ren, Zhenggang; Ye, Sheng‐Long; Sharma, Deewakar; Lin, Zhiying; Gan, Yuhong; Chen, Yi; Ge, Ning-lin; Ma, Zeng‐Chen; Wu, Zhi‐Quan; Fan, Jia; Qin, Lun‐Xiu; Zhou, Xin‐Da; Tang, Zhao‐You; Yang, Benlong

doi:10.1016/j.ejrad.2006.03.002

Cited by 149 publications

(115 citation statements)

References 14 publications

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“…If TACE procedures are carried out more frequently during a certain amount of time, they can result in continuous hepatic arterial damage caused by chemotherapeutic agent-induced inflammation or hypoxia caused by the embolic effect. 2,11,12 If the level of damage exceeds a certain point, morphologic change could happen suddenly and/or severely.…”

Section: Discussionmentioning

confidence: 99%

Angiographic evaluation of hepatic arterial injury after cisplatin and Gelfoam–based transcatheter arterial chemoembolization for hepatocellular carcinoma in a 205 patient cohort during a 6-year follow-up

Suh¹,

Jh²,

Hm³

et al. 2014

BJR

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Objective: To evaluate the overall and cumulative incidence, degree, interval change and predictors of hepatic arterial injury (HAI) after cisplatin and Gelfoam® (Upjohn, Kalamazoo, MI)-based transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). Methods: A total of 205 patients with HCC who underwent three or more sessions of TACE without additional surgical or local treatment were included. HAI was evaluated at each segment of the hepatic artery using a three-grade scale: 1 (slight wall irregularity), 2 (overt stenosis) and 3 (occlusion). HAI interval change was categorized into three groups: progression, stable state and improvement. Cumulative incidence of HAI was analysed using KaplanMeier method, and predictors of HAI (patient age, sex, portal vein thrombosis and Child-Pugh classification) were analysed by univariate logistic regression. Results: HAI occurred in 50 of the 205 study patients (24.4%). The cumulative incidence of HAI was 16.0% [95% confidence interval (CI), 10.21-21.77] during 5 sessions of TACE, 52.1% (95% CI, 37.83-66.29) during 10 sessions and 68.0% (95% CI, 67.62-88.46) during 15 sessions. Initial HAI was interpreted as grades 1, 2 and 3 in 11 (22.0%), 17 (34.0%) and 22 (44.0%) patients, respectively. When the interval change was assessed in 48 patients with available follow-up TACE, 40 (83.3%) were included in the progression, 2 (4.2%) in the stable state and 6 (12.5%) in the improvement groups. The univariate analysis used to determine the predictors of HAI revealed no significant predictors. Conclusion: In three or more sessions of TACE, the incidence of HAI was 24%. Increasing TACE causes increased incidence of HAI. The initial presentation was most commonly grade 3, and 12.5% of the patients with HAI showed improvement of the HAI grade during follow-up TACE. Advances in knowledge: In patients who underwent three or more sessions of cisplatin and Gelfoam-based TACE, the overall incidence of HAI was 24.4%, and increasing TACE causes increased incidence of HAI.

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Section: Discussionmentioning

confidence: 99%

Angiographic evaluation of hepatic arterial injury after cisplatin and Gelfoam–based transcatheter arterial chemoembolization for hepatocellular carcinoma in a 205 patient cohort during a 6-year follow-up

Suh¹,

Jh²,

Hm³

et al. 2014

BJR

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“…These side effects are in large part attributed to postembolization syndrome and include nausea, vomiting, abdominal pain, fever, and loss of appetite (7,8). Because the focus of most studies is patient survival rather than toxicities caused by TACE, precise analysis of potential TACE-induced systemic toxicities is lacking (9,10).…”

Section: H Epatocellular Carcinoma (Hcc)mentioning

confidence: 99%

Nonresectable Hepatocellular Carcinoma: Long-term Toxicity in Patients Treated with Transarterial Chemoembolization—Single-Center Experience

et al. 2008

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“…10 Martin et al discovered several risk factors to be associated with adverse events of drug-eluting beads, including lack of pretreatment with hepatic arterial lidocaine, 3 or more treatments, achievement of complete stasis, treatment with > 100 mg DEBIRI in a single treatment, and bilirubin > 2.0 mg/dL with > 50% liver involvement. 11 Biloma formation is a well-known complication of several surgical and interventional procedures including biliary surgery, liver transplantation, percutaneous cholangiography, biliary drainage, liver biopsy, 12-14 chemoembolization, chemoinfusion therapy, radiofrequency ablation, [14][15][16][17][18][19][20][21][22][23][24][25][26] cholecystectomy, 14,27,28 endoscopic retrograde cholangiopancreatography (ERCP), percutaneous ethanol injection, 14 and radioembolization. 29 A biloma is an encapsulated bile collection outside the biliary tree due to bile leakage.…”

Section: Discussionmentioning

confidence: 99%

Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Naumann¹,

Gupta²

2011

Semin intervent Radiol

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Chemoembolization with drug-eluting beads is a type of locoregional therapy currently being used for the treatment of hepatocellular carcinoma and metastatic disease to the liver. This treatment has proven effectiveness in controlling tumor growth, extending survival time, and improving quality of life. Chemoembolization with drug-eluting beads have been shown to be safe, but like any other invasive procedure, can have associated complications. The authors present a case of intrahepatic biloma formation occurring as a result of treatment with drug-eluting beads.

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Study of severe and rare complications of transarterial chemoembolization (TACE) for liver cancer

Cited by 149 publications

References 14 publications

Angiographic evaluation of hepatic arterial injury after cisplatin and Gelfoam–based transcatheter arterial chemoembolization for hepatocellular carcinoma in a 205 patient cohort during a 6-year follow-up

Angiographic evaluation of hepatic arterial injury after cisplatin and Gelfoam–based transcatheter arterial chemoembolization for hepatocellular carcinoma in a 205 patient cohort during a 6-year follow-up

Nonresectable Hepatocellular Carcinoma: Long-term Toxicity in Patients Treated with Transarterial Chemoembolization—Single-Center Experience

Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

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