Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma

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Abstract

Aim: To investigate the efficacy of transcatheter embolization/ chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. Methods: A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrast-enhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2, infused over 30 min using a peristaltic pump, and followed by Lipiodol and Gelfoam embolization. Results: Patients characteristics were: mean age, 62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size, 3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm, n = 51; 2.1-3.0 cm, n = 35; 3.1-4.0 cm, n = 29; 4.1-5.0 cm, n = 22; 5.1-6.0 cm, n = 11; and > 6.0 cm, n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%), massive (90%-99%) necrosis in 16 patients (10%), partial (50%-89%) necrosis in 18 patients (11%) and poor ( 6.0 cm, respectively. Kaplan-Mayer survival at 24-mo was 88%, 68%, 59%, 59%, 45%, and 53% for lesions of ≤ 2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, 5.1-6.0, and > 6.0 cm, respectively. Conclusion: Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm, TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis.

Original languageEnglish
Pages (from-to)2952-2955
Number of pages4
JournalWorld Journal of Gastroenterology
Volume13
Issue number21
Publication statusPublished - Jun 7 2007

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Hepatocellular Carcinoma
Necrosis
Therapeutics
Absorbable Gelatin Sponge
Ethiodized Oil
Neoplasms
Epirubicin
Spiral Computed Tomography
Survival
Pharmaceutical Preparations

Keywords

  • Hepatocellular carcinoma
  • Transcatheter embolization/chemoembolization

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{f336594e07354ae8982dc6b49fa9e682,
title = "Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma",
abstract = "Aim: To investigate the efficacy of transcatheter embolization/ chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. Methods: A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrast-enhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2, infused over 30 min using a peristaltic pump, and followed by Lipiodol and Gelfoam embolization. Results: Patients characteristics were: mean age, 62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size, 3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm, n = 51; 2.1-3.0 cm, n = 35; 3.1-4.0 cm, n = 29; 4.1-5.0 cm, n = 22; 5.1-6.0 cm, n = 11; and > 6.0 cm, n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58{\%}), massive (90{\%}-99{\%}) necrosis in 16 patients (10{\%}), partial (50{\%}-89{\%}) necrosis in 18 patients (11{\%}) and poor ( 6.0 cm, respectively. Kaplan-Mayer survival at 24-mo was 88{\%}, 68{\%}, 59{\%}, 59{\%}, 45{\%}, and 53{\%} for lesions of ≤ 2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, 5.1-6.0, and > 6.0 cm, respectively. Conclusion: Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm, TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis.",
keywords = "Hepatocellular carcinoma, Transcatheter embolization/chemoembolization",
author = "Roberto Miraglia and Giada Pietrosi and Luigi Maruzzelli and Ioannis Petridis and Settimo Caruso and Gianluca Marrone and Guiseppe Mamone and Giovanni Vizzini and Angelo Luca and Bruno Gridelli",
year = "2007",
month = "6",
day = "7",
language = "English",
volume = "13",
pages = "2952--2955",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "21",

}

TY - JOUR

T1 - Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma

AU - Miraglia, Roberto

AU - Pietrosi, Giada

AU - Maruzzelli, Luigi

AU - Petridis, Ioannis

AU - Caruso, Settimo

AU - Marrone, Gianluca

AU - Mamone, Guiseppe

AU - Vizzini, Giovanni

AU - Luca, Angelo

AU - Gridelli, Bruno

PY - 2007/6/7

Y1 - 2007/6/7

N2 - Aim: To investigate the efficacy of transcatheter embolization/ chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. Methods: A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrast-enhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2, infused over 30 min using a peristaltic pump, and followed by Lipiodol and Gelfoam embolization. Results: Patients characteristics were: mean age, 62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size, 3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm, n = 51; 2.1-3.0 cm, n = 35; 3.1-4.0 cm, n = 29; 4.1-5.0 cm, n = 22; 5.1-6.0 cm, n = 11; and > 6.0 cm, n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%), massive (90%-99%) necrosis in 16 patients (10%), partial (50%-89%) necrosis in 18 patients (11%) and poor ( 6.0 cm, respectively. Kaplan-Mayer survival at 24-mo was 88%, 68%, 59%, 59%, 45%, and 53% for lesions of ≤ 2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, 5.1-6.0, and > 6.0 cm, respectively. Conclusion: Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm, TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis.

AB - Aim: To investigate the efficacy of transcatheter embolization/ chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. Methods: A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrast-enhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2, infused over 30 min using a peristaltic pump, and followed by Lipiodol and Gelfoam embolization. Results: Patients characteristics were: mean age, 62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size, 3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm, n = 51; 2.1-3.0 cm, n = 35; 3.1-4.0 cm, n = 29; 4.1-5.0 cm, n = 22; 5.1-6.0 cm, n = 11; and > 6.0 cm, n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%), massive (90%-99%) necrosis in 16 patients (10%), partial (50%-89%) necrosis in 18 patients (11%) and poor ( 6.0 cm, respectively. Kaplan-Mayer survival at 24-mo was 88%, 68%, 59%, 59%, 45%, and 53% for lesions of ≤ 2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0, 5.1-6.0, and > 6.0 cm, respectively. Conclusion: Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm, TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis.

KW - Hepatocellular carcinoma

KW - Transcatheter embolization/chemoembolization

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M3 - Article

C2 - 17589945

AN - SCOPUS:34447104162

VL - 13

SP - 2952

EP - 2955

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 21

ER -