Transcatheter Arterial Chemoembolization Therapy for Patients With Unresectable Hepatocellular Carcinoma

Firouznia, Kavous; Alavian, Seyed Moayed; Azadeh, Payam; Toosi, Mohsen Nasiri; Mirzaian, Arya Haj; Najafi, Safa; Shakiba, Madjid; Jalali, Amir Hossein

doi:10.5812/hepatmon.25792

Cited by 9 publications

(7 citation statements)

References 35 publications

(37 reference statements)

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“…Our previous studies have found that, the injury and rupture of small artery in liver tissue may relate to the bleeding complication (14)(15)(16)(17). With the embolization agents, TAE can block small artery (18,19), achieving dual effects of haemostasis and delaying tumor growth. Therefore, the same prognosis is present in RHCC and NHCC patients.…”

Section: Discussionmentioning

confidence: 99%

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Wang¹,

Meng²,

Chen³

et al. 2022

Hepatobiliary Surg Nutr

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Background: This study aims to find out the possible optimal therapy and assess the prognosis properly for patient with spontaneous rupture of hepatocellular carcinoma (HCC).Methods: Propensity score matching (PSM) analysis was used to study the data from 325 patients with ruptured HCC (RHCC) and 2,291 patients with non-RHCC.Results: The incidence and hospital mortality of RHCC were 5.1% and 0.8% respectively, with a median overall survival (OS) time of 17 months. There was no difference between ruptured and non-RHCC patients undergoing conservation treatment in terms of OS. Trans-arterial embolization (TAE) was carried out in 69 (21.2%) cases with RHCC, with a median OS of 7 months, which was no difference from that of non-RHCC (pre-and post-PSM). One hundred and sixty-nine (52.0%) RHCC cases underwent one-stage hepatectomy, with a median OS and disease-free survival (DFS) of 30 and 6 months respectively, which were shorter than that of non-RHCC (post-PSM). TAE plus two-stage hepatectomy was performed in 30 RHCC cases, with a median OS and DFS of 28 and 10 months respectively; these outcomes were better than that from RHCC patients undergoing TAE alone or one-stage hepatectomy (post-PSM), which were no difference from that of non-RHCC patients undergoing hepatectomy. The risk of death for RHCC patient undergoing one-stage hepatectomy is 1.545 times higher than that of one undergoing TAE + two-stage hepatectomy.Conclusions: TAE plus two-stage hepatectomy might be the optimal treatment for RHCC patient. Under the premise of the same pathological properties, there is no difference in prognosis between ruptured and non-RHCC patients if the therapy is appropriate.

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Section: Discussionmentioning

confidence: 99%

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Wang¹,

Meng²,

Chen³

et al. 2022

Hepatobiliary Surg Nutr

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“…Because multiple variables affect the clinical course of HCC, [ 11 ] the number of studies comparing TACE to conservative management remains limited. [ 12 , 13 ]…”

Section: Introductionmentioning

confidence: 99%

Transarterial chemoembolization extends long-term survival in patients with unresectable hepatocellular carcinoma

Kong¹,

Li²,

Fan

et al. 2018

Medicine

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The long-term survival benefit of treating unresectable hepatocellular carcinoma (HCC) patients with transarterial chemoembolization (TACE) rather than conservative treatment remains controversial. This retrospective case-control study evaluated the survival of patients with unresectable HCC treated with TACE, relative to that of patients who received best supportive care.From January 2002 to December 2010, 522 of 2386 consecutive patients with unresectable HCC were enrolled. Patients were treated with TACE (n = 347) or best supportive care (non-TACE; n = 175). A survival analysis compared the survival of the 2 groups, as well as only those at Barcelona Clinic Liver Cancer Classification (BCLC)-C and Child-Pugh-B (39 TACE, 61 non-TACE).The median follow-up was 5 months (0.15–106 months).The overall median survival of the TACE group (8.0 months) was significantly longer than that of the non-TACE (2.0 months; P ≤ .01). Of the patients at BCLC-C and Child-Pugh-B, the overall median survivals of the TACE and non-TACE patients were 6.0 and 2.0 months, respectively (P ≤ .01); and the 1, 2, 3, 5, and 8-year overall survival rates were significantly superior in the TACE group (P ≤ .01). For all the patients, the independent predictors of survival were treatment modalities, portal vein tumor thrombosis, alpha-fetoprotein, and BCLC stage. Regarding the TACE patients, contributors to prognosis were portal vein tumor thrombosis, alpha-fetoprotein level, and the number of TACE procedures.TACE for unresectable HCC was associated with longer survival compared with best supportive care, especially for patients at BCLC-C and Child-Pugh-B.

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“…The majority of adverse events, however, were in the realm of post-embolization syndrome. Furthermore, elevations of ALT or AST occurred with significant frequency within 48 h after dTACE, albeit with no significant change in liver toxicity compared with pre-dTACE within 2 months (as with cTACE) (35).…”

Section: Discussionmentioning

confidence: 88%

Efficacy and safety of drug‑eluting beads for transarterial chemoembolization in patients with advanced hepatocellular carcinoma

et al. 2019

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Hepatocellular carcinoma (HCC) has more recently become a leading cause of cancer-associated mortality worldwide. Particularly at an advanced stage, the prognosis is generally poor due to lack of effective treatments. Transarterial chemoembolization (TACE) is now a recognized therapy for advanced HCC, serving to deprive tumors of feeder arteries through induced ischemic necrosis. However, there is also a potential for undesired circulatory toxicity owing to drug reflux from tumor artery to surrounding healthy tissues. Although effective chemotherapeutic drug concentrations are thus lowered, the side effects of systemic chemotherapy are aggravated. The mid-2000 emergence of drug-eluting beads (DEB) loaded with anti-neoplastic drugs has proven particularly advantageous, enabling localized treatment and directed delivery of chemotherapeutics. DEB-TACE (dTACE) augments local infusion of anti-neoplastic agents to prolong agent/tumor contact, expanding upon conventional TACE. At present, data on DEB use in China are limited, particularly in terms of proprietary microspheres (CalliSpheres; Hengrui Medicine Co.). To explore the efficacy and safety of CalliSpheres, A total of 90 patients receiving this means of dTACE for advanced HCC were assessed in the present study. Clinical efficacy was evaluated based on tumor response and overall survival rates using the National Cancer Institute Common Terminology Criteria for Adverse Events to assess tolerability. The satisfactory tumor response and acceptable tolerability demonstrated in the follow-up confirm the promising utility of CalliSpheres in treating patients with advanced HCC.

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Transcatheter Arterial Chemoembolization Therapy for Patients With Unresectable Hepatocellular Carcinoma

Cited by 9 publications

References 35 publications

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Transarterial chemoembolization extends long-term survival in patients with unresectable hepatocellular carcinoma

Efficacy and safety of drug‑eluting beads for transarterial chemoembolization in patients with advanced hepatocellular carcinoma

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