Transcatheter Arterial Chemoembolization Therapy for Patients With Hepatocellular Carcinoma: A Case-Controlled Study

Biselli, Maurizio; Andreone, Pietro; Gramenzi, Annagiulia; Trevisani, Franco; Cursaro, Carmela; Rossi, Cristina; Rosellini, Salvatore Ricca; Cammà, C.; Lorenzini, Stefania; Stefanini, Giuseppe Francesco; Gasbarrini, Giovanni; Bernardi, Mauro

doi:10.1016/s1542-3565(05)00425-8

Cited by 33 publications

(19 citation statements)

References 51 publications

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“…The great variety of therapeutic options allows on the one side the search for the most convenient/cost effective therapy for each center, but on the other side, emphasizes the loss of the optimal option, which could be available and applicable in most cases [38][39][40][41][42][43][44]. However, some agreement was reached in the past years, i.e., that LT is recognized as the best therapy option for these patients under the presupposition that the HCC does not exceed certain pre-established criteria and the candidate has an acceptable surgical risk [28,[45][46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Liver Transplantation, Liver Resection, and Transarterial Chemoembolization for Hepatocellular Carcinoma in Cirrhosis: Which Is the Best Oncological Approach?

et al. 2008

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The aim of the study was to evaluate our institutional experience with monotherapies for hepatocellular carcinoma (HCC) in the setting of cirrhosis. A retrospective cohort study was carried out at the tertiary care academic referral center and involved 185 consecutive HCC patients with cirrhosis and no previous treatment who underwent resection (n = 61), transarterial chemoembolization (TACE) (n = 64), or liver transplantation (LT) (n = 60). Long-term survival and survival according to the Milan criteria were the main outcomes measured. Median survival after resection, TACE, and LT was 11, 14, and 23 months, respectively. Five-year cumulative survival after resection, TACE, and LT was 23, 10, and 59%, respectively (P = 0.001). Five-year cumulative disease-free survival after resection and LT was 15% and 77%, respectively (P = 0.002). The presence of complications in the resection group (P = 0.004), MELD score (P = 0.0003), and maximum tumor diameter (P = 0.05) in the TACE group, and tumor grade (P = 0.01) and complications (P = 0.004) in the LT group were found to be independent predictors of survival. Five-year survival for patients within the Milan criteria after resection, TACE, and LT was 26, 37, and 66%, respectively. Five-year survival for patients outside the Milan criteria for patients undergoing LT was 53%. The results suggest that LT represents the best oncological treatment option for patients with HCC in the setting of cirrhosis, even for those beyond the Milan criteria. Considering the scarcity of available organs, liver resection remains the best alternative option. TACE remains a potential therapy in patients within the Milan criteria, where it may be more beneficial than resection.

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Section: Discussionmentioning

confidence: 99%

Liver Transplantation, Liver Resection, and Transarterial Chemoembolization for Hepatocellular Carcinoma in Cirrhosis: Which Is the Best Oncological Approach?

et al. 2008

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“…Our data demonstrate that the patients, who have no tumor progression after TACE benefit substantially from OLT. Whether these patients would progress without TACE remains speculative [19,[21][22][23][24][25][26] . In contrast to other malignant diseases, assessment of HCC patients on the waiting list should not only account for the current stage, it although should evaluate the tumor progression.…”

Section: Discussionmentioning

confidence: 99%

Patients without hepatocellular carcinoma progression after transarterial chemoembolization benefit from liver transplantation

Obed

Beham

Püllmann³

et al. 2007

WJG

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“…The intended duration of arterial occlusion is not permanent since this would interfere with future chemoembolization if it became clinically desirable. The combination of cytotoxic chemotherapy and embolization achieves varying degrees of tumor necrosis [26,27] , but achieving even complete necrosis has not necessarily been predictive of postLT survival [16] . The outcome of TACE must be assessed with two questions in mind.…”

Section: Intra-arterial Chemotherapymentioning

confidence: 99%

Loco-regional therapies for patients with hepatocellular carcinoma awaiting liver transplantation: Selecting an optimal therapy

Byrne

Rakela

2016

WJT

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Hepatocellular carcinoma (HCC) is a common, increasingly prevalent malignancy. For all but the smallest lesions, surgical removal of cancer via resection or liver transplantation (LT) is considered the most feasible pathway to cure. Resection -even with favorable survival -is associated with a fairly high rate of recurrence, perhaps since most HCCs occur in the setting of cirrhosis. LT offers the advantage of removing not only the cancer but the diseased liver from which the cancer has arisen, and LT outperforms resection for survival with selected patients. Since time waiting for LT is time during which HCC can progress, locoregional therapy (LRT) is widely employed by transplant centers. The purpose of LRT is either to bridge patients to LT by preventing progression and waitlist dropout, or to downstage patients who slightly exceed standard eligibility criteria initially but can fall within it after treatment. Transarterial chemoembolization and radiofrequency ablation have been the most widely utilized LRTs to date, with favorable efficacy and safety as a bridge to LT (and for the former, as a downstaging modality). The list of potentially effective LRTs has expanded in recent years, and includes transarterial chemoembolization with drug-eluting beads, radioembolization and novel forms of extracorporal therapy. Herein we appraise the various LRT modalities for HCC, and their potential roles in specific clinical scenarios in patients awaiting LT.

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Transcatheter Arterial Chemoembolization Therapy for Patients With Hepatocellular Carcinoma: A Case-Controlled Study

Cited by 33 publications

References 51 publications

Liver Transplantation, Liver Resection, and Transarterial Chemoembolization for Hepatocellular Carcinoma in Cirrhosis: Which Is the Best Oncological Approach?

Liver Transplantation, Liver Resection, and Transarterial Chemoembolization for Hepatocellular Carcinoma in Cirrhosis: Which Is the Best Oncological Approach?

Patients without hepatocellular carcinoma progression after transarterial chemoembolization benefit from liver transplantation

Loco-regional therapies for patients with hepatocellular carcinoma awaiting liver transplantation: Selecting an optimal therapy

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