Ultraselective conventional transarterial chemoembolization: When and how?

Miyayama, Shiro

doi:10.3350/cmh.2019.0016

Cited by 41 publications

(38 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found no significant difference between the TACE and RFA groups with regard to the 5-year OS rate in early-stage HCC patients. In other words, when RFA is not technically feasible, patients with early-stage HCC, including those with a single tumor, can achieve the same therapeutic benefit in terms of OS through TACE [25], although, as expected, the TACE group had a poorer CR and 5-year RFS rate than the RFA group.…”

Section: Discussionsupporting

confidence: 59%

Prognosis of Early-Stage Hepatocellular Carcinoma: Comparison between Trans-Arterial Chemoembolization and Radiofrequency Ablation

Yun

Lee

Min

et al. 2020

Cancers

View full text Add to dashboard Cite

Radiofrequency ablation (RFA) is a curative treatment for early-stage hepatocellular carcinoma (HCC) ineligible for surgery or liver transplantation. However, trans-arterial chemoembolization (TACE) might be an alternative when RFA is contraindicated due to structural problems. Here, we aimed to compare their long-term outcomes. Treatment-naive HCC patients fulfilling the Milan criteria who underwent RFA (n = 136) or TACE (n = 268) were enrolled. Complete response (CR) and 5-year recurrence-free survival (RFS) rates were higher in the RFA group than in the TACE group (94.1% vs. 71.6% and 35.8% vs. 17.0%, respectively; both p < 0.001), whereas 5-year overall survival (OS) rates were not significantly different (65.5% vs. 72.3%, respectively; p = 0.100). Multivariate analysis showed that RFA was associated with better RFS (adjusted hazard ratio [aHR] 0.628; p = 0.001) than TACE, but not with better OS (aHR 1.325; p = 0.151). The most common 1st-line treatment after recurrence were TACE (n = 53), followed by RFA (n = 21) among the RFA group and TACE (n = 150), followed by RFA (n = 44) among the TACE group. After propensity-score matching, similar results were reproduced. Hence, TACE could be an effective alternative to RFA in terms of OS rates. However, TACE should be confined only to RFA-difficult cases, given its lower CR and RFS rates and multi-disciplinary approaches are desirable in decision-making.

show abstract

Section: Discussionsupporting

confidence: 59%

Prognosis of Early-Stage Hepatocellular Carcinoma: Comparison between Trans-Arterial Chemoembolization and Radiofrequency Ablation

Yun

Lee

Min

et al. 2020

Cancers

View full text Add to dashboard Cite

show abstract

“…TACE can increase the risk of liver function failure especially in patients with Child-Pugh B cirrhosis because it can damage the liver parenchyma and the hepatic artery. Thus, Child-Pugh C liver function is mainly regarded as a contraindication for TACE [21, 22].…”

Section: Transarterial Chemoembolizationmentioning

confidence: 99%

The Combination Strategy of Transarterial Chemoembolization and Radiofrequency Ablation or Microwave Ablation against Hepatocellular Carcinoma

Xie

Zhou

et al. 2019

Analytical Cellular Pathology

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver. Hepatectomy and liver transplantation (LT) are regarded as the radical treatment, but great majority of patients are already in advanced stage on the first diagnosis and lose the surgery opportunity. Multifarious image-guided interventional therapies, termed as locoregional ablations, are recommended by various HCC guidelines for the clinical practice. Transarterial chemoembolization (TACE) is firstly recommended for intermediate-stage (Barcelona Clinic Liver Cancer (BCLC) B class) HCC but has lower necrosis rates. Radiofrequency ablation (RFA) is effective in treating HCCs smaller than 3 cm in size. Microwave ablation (MWA) can ablate larger tumor within a shorter time. Combination of TACE with RFA or MWA is effective and promising in treating larger HCC lesions but needs more clinical data to confirm its long-term outcome. The combination of TACE and RFA or MWA against hepatocellular carcinoma needs more clinical data for a better strategy. The characters and advantages of TACE, RFA, MWA, and TACE combined with RFA or MWA are reviewed to provide physician a better background on decision.

show abstract

“…or smaller. [6][7][8][9] The triaxial system was previously shown to be useful for super-selective catheterization under various conditions. 5 In particular, it should be very effective for cases which definitely need super-selective catheterization, such as those with pseudoaneurysm, gastrointestinal bleeding, or type 2 endoleak after EVAR.…”

Section: Discussionmentioning

confidence: 99%

Use of 0.014-in. pushable bare platinum coils in super-selective embolization through the 1.6-Fr. microcatheter of the triaxial system

Tsukahara

Shimohira

Nagai

et al. 2020

Acta Radiologica Open

View full text Add to dashboard Cite

Background A triple-coaxial (triaxial) system, which consists of a small microcatheter, a large microcatheter, and a 4-Fr. catheter, has been reported to allow super-selective catheterization. A 1.6-Fr. microcatheter has recently become available as the small microcatheter for the triaxial system, in addition to 0.014-in. pushable bare platinum coils that may be introduced into the 1.6-Fr. microcatheter. Purpose The purpose of the present study was to evaluate the feasibility of 0.014-in. pushable bare platinum coils in embolization through the 1.6-Fr. microcatheter of the triaxial system. Material and Methods Between November 2015 and October 2019, 19 embolizations were performed on 18 patients, 9 males and 9 females with a median age of 77 years (range, 41–88 years), using 0.014-in. pushable bare platinum coils through the 1.6-Fr. microcatheter of the triaxial system. The technical success rate, clinical success rate, and complications associated with the procedure were assessed. Technical success was defined as the successful delivery and placement of 0.014-in. pushable bare platinum coils, and clinical success as the immediate postembolic complete cessation of blood flow confirmed by digital subtraction angiography. Results Eighty-four 0.014-in. pushable bare platinum coils were delivered and 19 arteries were successfully embolized. The median number of 0.014-in. pushable bare platinum coils was 4 (range, 1–12). The technical success rate was 100% (84/84) and the clinical success rate was also 100% (19/19). There were no complications associated with the procedures. Conclusion The use of 0.014-in. pushable bare platinum coils in super-selective embolization through the 1.6-Fr. microcatheter of the triaxial system appears to be feasible and safe.

show abstract

Ultraselective conventional transarterial chemoembolization: When and how?

Cited by 41 publications

References 47 publications

Prognosis of Early-Stage Hepatocellular Carcinoma: Comparison between Trans-Arterial Chemoembolization and Radiofrequency Ablation

Prognosis of Early-Stage Hepatocellular Carcinoma: Comparison between Trans-Arterial Chemoembolization and Radiofrequency Ablation

The Combination Strategy of Transarterial Chemoembolization and Radiofrequency Ablation or Microwave Ablation against Hepatocellular Carcinoma

Use of 0.014-in. pushable bare platinum coils in super-selective embolization through the 1.6-Fr. microcatheter of the triaxial system

Contact Info

Product

Resources

About