Transcatheter arterial chemoembolization therapy using iodized oil for patients with unresectable hepatocellular carcinoma

Ueno, Kazuto; Miyazono, Nobuaki; Inoue, Hiroki; Nishida, Hitoshi; Kanetsuki, I; Nakajo, Masayuki

doi:10.1002/(sici)1097-0142(20000401)88:7<1574::aid-cncr11>3.0.co;2-8

Cited by 57 publications

(32 citation statements)

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“…Various mixtures of anticancer drugs, Lipiodol and gelatin sponge have been used as TACE agents. There have been a few reports on comparison of the efficacy of different TACE regimens on HCC patients [3] . Cellular homeostasis in tissue depends on the balance between apoptosis and cell proliferation.…”

Section: Introductionmentioning

confidence: 99%

Effects of p53 on apoptosis and proliferation of hepatocellular carcinoma cells treated with transcatheter arterial chemoembolization

Xiao¹,

Li²,

Huang³

2004

WJG

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AIM:To evaluate the effects of p53 on apoptosis and proliferation of hepatocellular carcinoma (HCC) cells treated with transcatheter arterial chemoembolization (TACE). METHODS:A total of 136 patients with HCC received TACE and other management before surgery were divided into TACE group and non-TACE group. TACE group included 79 patients who had 1-5 courses of TACE before surgery, of them, 11 patients had 1-4 courses of chemotherapy (group A), 33 patients had 1-5 courses of chemotherapy combined with iodized oil (group B), 23 patients had 1-3 courses of chemotherapy, iodized oil and gelatin sponge (group C), 12 patients had 1-3 courses of chemotherapy combined with iodized oil, ethanol and gelatin sponge (group D). Non-TACE group included the remaining 57 patients who had surgery only. The extent of apoptosis was analyzed by transferase mediated dUTP nick end labeling (TUNEL) staining. The expressions of p53, Bcl-2, Bax, Ki-67 and PCNA protein were detected by immunohistochemical method.RESULTS: P53 protein expressions in trabecular and clear cells in HCC specimens were significantly lower than that in pseudoglandar, solid, poorly differentiated or undifferentiated and sclerosis HCC (P<0.05). Expression of p53 protein in HCC cells increased with the increase of pathological grades (P<0.05), and correlated positively with expressions of Ki-67 and PCNA protein, and negatively with Bcl-2 to Bax protein expression rate and AI (P<0.05). Expression of p53 protein was significantly higher in group A than in groups B, C, D and the non-TACE group, and was higher in group B than in groups C and D, and lower in group D than in the non-TACE group (P<0.05). CONCLUSION:Expression of p53 protein can enhance proliferation of HCC cells and suppress apoptosis of HCC cells after TACE.Xiao EH, Li JQ, Huang JF. Effects of p53 on apoptosis and proliferation of hepatocellular carcinoma cells treated with transcatheter arterial chemoembolization.

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Section: Introductionmentioning

confidence: 99%

Effects of p53 on apoptosis and proliferation of hepatocellular carcinoma cells treated with transcatheter arterial chemoembolization

Xiao¹,

Li²,

Huang³

2004

WJG

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“…Tümöre ait faktörler; tümör çapının 5 cm'den büyük olması, multinodüler veya diffüz tutulum olması, bilobar olması, karaciğerin %50'den fazlasının tutulması, uzak metastaz varlığı ve vasküler invazyon olması kötü prognoz göstergesi iken tek 5cm'den küçük nodüler tümörlerde prognoz daha iyi olduğunu gösteren çalışmalar mevcuttur. 10,13,14 Karaciğer rezervini gösteren faktörler ise serum albumin, serum bilirübin değerleri, asit varlığı, Childpugh skoru sayılabilir. Ayrıca Okuda III, portal ven trombozu, serum AFP değerinin 400 IU/dl üstünde olması ile TAKE sonrasında lipiodol tutulumunun az veya olmaması pronozu kötü etkileyen diğer faktörlerdir.…”

Section: Discussionunclassified

“…Ayrıca Okuda III, portal ven trombozu, serum AFP değerinin 400 IU/dl üstünde olması ile TAKE sonrasında lipiodol tutulumunun az veya olmaması pronozu kötü etkileyen diğer faktörlerdir. 10,13,15 Bizim çalışmamızda tedavi öncesi tümör çapı-nın 5 cm'den büyük olması,diffüz tutulum olması, asit olması, serum albumin değerinin 2.8 mg/dl altında olması, bilirübin değeri 3 mg/dl nin üstünde olması ve Child-C olması kötü pognoz göstergesi olduğu görüldü ve litertürdeki bilgilerle uyumlu idi. Çalışmamızda karaciğerin %50'sinin altında tümör tutlumu olan hastalar ile %50'sinin üzerinde olan tümör tutlumu gurup karşılaştırıldığında sağkalım açısından anlamlı fark bulunamamıştır (p=0.151).…”

Section: Discussionunclassified

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The effect of transarterial chemoembolization therapy to survival in unresectable liver tumors

Çetinçakmak¹

2011

Dicle Med J

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Objectives: The aim of this study was to investigate the effect of Transarterial Chemoembolization (TAKE) on tumor response survival in patients with hepatocellular carcinoma (HCC) between January 2002 and December 2008. Materials and methods:In 33 unresectable HCC patients TACE treatment was administered 59 times. Lipiodol + epirubycin hidrochlorur emulsion and lipiodol were administered to HCC for 1-4 times (mean 1.78) via the hepatic artery, selectively. Patients were examined at 1st, 2nd, and 4th months with abdomen CT, serum albumin, bilirubin, PT, AFP levels. Procedure was repetaed in case of growth in the initial mass size or enhancing solid portion of tumor on the CT images.Results: In our study, tumor size above 5 cm, diffuse involvement, ascites, serum albumin level below 2.8 g/ dl, bilirubin level above 3 mg/dl, Child C stage, Okuda III stage, serum AFP level above 400 IU/dl and low lipiodol involvement were considered as poor prognostic factors. Tumor size below 5 cm, nodularity, absence of ascites, serum albumin levels above 3.5 g/dl, bilirubin levels below 1 mg/dl, Child A stage, Okuda I stage and high lipiodol involvement were found as good prognostic factors. Conclusion:In present study, we found that repetitive TACE procedures improved the survival in selected unresectable HCC patients Gereç ve yöntem:Cerrahi tedavi yapılamayan 33 HCC tanılı olguya 59 defa TAKE tedavisi uygulandı. Hastalara 1-4 defa (ortalama 1.78 kez) lipiodol+epirubicin hidroklorür emülsiyonu ile lipiodol hepatik arter yoluyla selektif olarak verildi. Hastalar 1, 2 ve 4. ayda abdomen bilgisayarlı tomografi (BT) ve serum albumin, bilirubin, protrombin zamanı (PT), a-fetoprotein (AFP) değerleri ile takip edildi. BT' de kontrastlanan solid tümör varlığı ve kitle çapı artışı durumlarında işlem tekrar edildi. Bulgular: Çalışmamızda HCC hastalarının tedavi önce-si tümör çapının 5 cm'den büyük olması, diffüz tutulum olması, asit olması, serum albumin değerinin 2.8 g/dl'nin altında olması, bilirubin değeri 3 mg/dl'nin üstünde olması, Child-C evresinde olması, Okuda III evresi ve serum AFP değerinin 400 IU/dl üstünde olması ve lipiodolün az tutulumu kötü prognoz göstergesi olarak saptandı. Tümör boyutu 5 cm'nin altında olması, nodüler olması, asitin olmaması, hastanın serum albuminin >3.5 mg/dl ve bilirubinin<1 mg/dl olması, Child-A olması, Okuda I evresinde olması ve lezyonun lipiodolü yoğun tutması iyi prognostik faktörler olarak bulundu.Sonuç: Çalışmamızda cerrahi tedavi yapılamayan seçil-miş HCC olgularında TAKE işleminin tekrarlarında sağka-lımın istatistiksel olarak arttığı görüldü.

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“…Transarterial chemoembolization (TACE) has been widely practiced in the treatment of unresectable hepatocellular carcinoma (HCC) [1][2][3][4][5] , but long-term TACE therapy was as yet unsatisfactory [6][7][8] . Histopathologic examination showed although TACE could induce significant necrosis, yet complete tumor necrosis was rare, the residual tumor cells remained viable in the peripheral region, which may play an important role in local recurrence or as a source of metastasis affecting the long-term efficacy of TACE [9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Influence of transarterial chemoembolization on angiogenesis and expression of vascular endothelial growth factor and basic fibroblast growth factor in rat with Walker-256 transplanted hepatoma: An experimental study

Li¹,

Feng²,

Zheng³

et al. 2003

WJG

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AIM:After transarterial chemoembolization (TACE), the residual cancer cells are under extensive hypoxic or even anoxic environment. Hypoxia can lead to adaptive responses. For example, angiogenesis will help these cells survive. In this study, we examined the effect of TACE on angiogenesis and expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF) and to assess their relevance to Walker-256 transplanted hepatoma. METHODS:Male Wistar rats were inoculated with Walker-256 tumor in the left lobe of liver. Angiography and transarterial chemoembolization were performed at d14 after transplantation. Sixty rats bearing walker-256 transplanted hepatoma were randomly divided into control group, arterial infusion group and TACE group. Each group consisted of twenty rats. Normal saline, 5-Fu, 5-Fu and lipiodol were infused through hepatic artery respectively. Two weeks after the infusion, staining of factor VIII, VEGF and b-FGF was performed by immunohistochemistry method in routine paraffin-embeded sections. Microvessel density (MVD) was counted in endothelial cells with positive factor VIII. Their expression levels were analyzed in conjunction with the pathologic features. RESULTS:While a smaller tumor volume was found in TACE group (F=37.818, P<0.001), no statistical differences between MVD and expression of VEGF and b-FGF were found among the 3 groups. MVD of the control group, chemotherapy group and chemoemoblization group was 80.84±24. 24, 83.05±20.29 and 85.20±23.91 (F=0.193, P=0.873

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Transcatheter arterial chemoembolization therapy using iodized oil for patients with unresectable hepatocellular carcinoma

Cited by 57 publications

References 37 publications

Effects of p53 on apoptosis and proliferation of hepatocellular carcinoma cells treated with transcatheter arterial chemoembolization

Effects of p53 on apoptosis and proliferation of hepatocellular carcinoma cells treated with transcatheter arterial chemoembolization

The effect of transarterial chemoembolization therapy to survival in unresectable liver tumors

Influence of transarterial chemoembolization on angiogenesis and expression of vascular endothelial growth factor and basic fibroblast growth factor in rat with Walker-256 transplanted hepatoma: An experimental study

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