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Transarterial Chemoembolization

Myung Han Hyun, Young-Sun Lee, Ji Hoon Kim, Chan Uk Lee, Young Kul Jung, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun
According to the American Association for the Study of Liver Disease treatment guidelines for hepatocellular carcinoma (HCC), the role of surgery has been expanded beyond the Barcelona Clinic Liver Cancer (BCLC) algorithm. We compared primary hepatectomy (PH) with transarterial chemoembolization (TACE) in patients with intermediate to advanced (BCLC stage-B/C) stage HCC to determine the current evidence. Through database search, we included 18 high-quality studies (1 randomized controlled trial [RCT], 5 propensity-score matching non-randomized comparative trials [NRCT], and 12 NRCTs) that compared survival outcomes of 5,986 patients after PH and TACE...
March 15, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Sang Min Yoon, Baek-Yeol Ryoo, So Jung Lee, Jong Hoon Kim, Ji Hoon Shin, Ji Hyun An, Han Chu Lee, Young-Suk Lim
Importance: Patients with hepatocellular carcinoma showing macroscopic vascular invasion have a poor prognosis. Sorafenib is the sole treatment option for these patients, with unsatisfactory response and survival benefit. Combined treatment with transarterial chemoembolization (TACE) plus external beam radiotherapy (RT) has shown promising results for these patients in observational studies. Objective: To evaluate the efficacy and safety of TACE plus RT compared with sorafenib for patients with hepatocellular carcinoma and macroscopic vascular invasion...
March 15, 2018: JAMA Oncology
Jennifer Gill, Andrei Baiceanu, Paul J Clark, Andrew Langford, Julianah Latiff, Pei-Ming Yang, Eric M Yoshida, Panos Kanavos
AIM: To better understand the hepatocellular carcinoma (HCC) patient journey, we conducted a patient survey across 13 countries. METHODS: The survey included closed- and open-ended questions developed using an iterative process to gather information on demographics, diagnosis and treatment. Patients self-selected or were directed to the online survey by their doctor. RESULTS: A total of 256 patients completed the survey. More than two-thirds (68%) felt they did not receive enough information about HCC at diagnosis...
March 15, 2018: Future Oncology
Hiroto Matsuda, Satoshi Tamada, Minoru Kato, Akira Yamamoto, Taro Iguchi, Tatsuya Nakatani
A 73-year-old woman with chief complaint of macroscopic hematuria was diagnosed as having left renal tumor with pancreatic invasion. Nephrectomy was performed. Pathological diagnosis was clear cell carcinoma, pT3a. Three months after the operation, liver metastasis appeared and sunitinib was started. Most of the liver metastases disappeared; however, a new lesion appeared, and sunitinib was switched to axitinib, which was effective on the residual lesion, but the new lesion had poor response. Transarterial chemoembolization was performed to treat the liver metastases, and all metastatic lesions disappeared...
March 2018: Urology Case Reports
Sebastian Buschauer, Andreas Koch, Philipp Wiggermann, Martina Müller, Claus Hellerbrand
Transarterial chemoembolization (TACE) is an established therapeutic approach for the treatment of hepatocellular carcinoma (HCC). Although patients who undergo TACE may have prolonged survival, there are indications that the malignancy of residual HCC tissue can increase subsequent to the procedure. Although hypoxia, which occurs during TACE due to ischemia, is known to contribute to angiogenesis, little is known with regard to the undesirable effects of chemotherapeutic agents on residual HCC cells. Doxorubicin is one of the most commonly used drugs in TACE...
April 2018: Oncology Letters
Chun Han Nigel Tan, Yue Yu, Yan Rui Nicholas Tan, Boon Leng Kieron Lim, Shridhar Ganpathi Iyer, Krishnakumar Madhavan, Alfred Wei Chieh Kow
Backgrounds/Aims: Liver Transplantation (LT) is a recognized treatment for Hepatocellular Carcinoma (HCC). The role of Bridging Therapies (BT) remains controversial. Methods: From January 2001 to October 2012, 192 patients were referred to the National University Hospital, Singapore for consideration of LT for HCC. Sixty-five patients (33.8%) were found suitable for transplant and were placed on the waitlist. Analysis was performed in these patients. Results: The most common etiology of HCC was Hepatitis B (n=28, 43...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
H Abdella, M K Shaker, Iman Fawzy Montasser, M Sobhi, H Aly, A Sayed, S Saleh, A El Dorry
BACKGROUND/AIM: Portal vein tumor thrombosis (PVTT) is a common complication in hepatocellular carcinoma (HCC) and it was considered a relative contraindication for transarterial chemoembolization (TACE) by many centers. This study aimed to assess the outcomes after TACE in patients with branch PVT regarding Child classification, radiological response, and 1-year survival. METHODS: Thirty HCC patients (24 male, 6 females) Child A cirrhotics with branch PVT underwent TACE...
March 13, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Gulziya Ismailova, Eugene Yenin, Shokan Kaniev, Dinara Bayguisova, Talgat Tajibaev
OBJECTIVES: Hepatocellular carcinoma is the predominant malignancy in patients with cirrhosis and chronic liver disease. Our aim was to assess the morphologic, radiologic, and immunologic charac teristics of hepatocellular carcinoma and liver cirrhosis concerning surgical treatment tactics. MATERIALS AND METHODS: We performed a cross-sectional analysis of a prospective study performed at the JSC National Scientific Center of Surgery (named after A. Syzganov). The study included 58 patients: 31 with hepatocellular carcinoma (53...
March 2018: Experimental and Clinical Transplantation
N Golse, A El Bouyousfi, F Marques, B Bancel, K Mohkam, C Ducerf, P Merle, M Sebagh, D Castaing, A Sa Cunha, R Adam, D Cherqui, E Vibert, J-Y Mabrut
BACKGROUND: Hepatectomy remains the standard treatment for large hepatocellular carcinoma (LHCC) ≥5cm. Fibrosis may constitute a contraindication for resection because of high risk of post-hepatectomy liver failure, but its impact on patient outcome and cancer recurrence remains ill defined. Our aim was to compare predictors of survival in patients with and without cirrhosis following hepatectomy for LHCC. METHODS: The data on consecutive patients undergoing hepatectomy for LHCC in two tertiary centres between 2012 and 2016 were reviewed...
March 7, 2018: Journal of Visceral Surgery
Peter Popovic, Ana Leban, Klara Kregar, Manca Garbajs, Rok Dezman, Matjaz Bunc
Background: The purpose of this retrospective cohort study was to evaluate the clinical value of computed tomographic perfusion imaging (CTPI) parameters in predicting the response to treatment and overall survival in patients with hepatocellular carcinoma (HCC) treated with drug-eluting beads transarterial chemoembolization (DEBTACE). Patients and methods: Between December 2010 and January 2013 eighteen patients (17 men, 1 woman; mean age 69 ± 5.8 years) with intermediate stage HCC underwent CTPI of the liver prior to treatment with DEBTACE...
March 2018: Radiology and Oncology
Lin Zheng, Hai-Liang Li, Chen-Yang Guo, Su-Xia Luo
Objective: To evaluate the efficacy and prognostic factors associated with transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) versus TACE alone for a large solitary or multinodular hepatocellular carcinomas (HCCs). Materials and Methods: This retrospective study involved 258 patients with a large solitary or multinodular HCCs (not more than 10 tumors) who underwent TACE + MWA (n = 92) or TACE alone (n = 166) between July 2011 and April 2015...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Kai Zhang, Xiangyang Sun, Fubo Xie, Wencheng Jian, Caixia Li
Objective: The aim is to study the effectiveness and side effects of sorafenib administration after transarterial chemoembolization (TACE) in advanced hepatocellular carcinoma (HCC) patients. To evaluate the safety of the combination of sorafenib and TACE to treat HCC. Materials and Methods: A total of 36 unresectable HCC patients were enrolled. After TACE, administration of sorafenib was carried out. Follow-up was taken for every 4 weeks. Liver and renal function and alpha-fetoprotein were tested...
January 2018: Journal of Cancer Research and Therapeutics
Lin-Zhong Zhu, Ren-Jie Yang, Xu Zhu
Background: Lung metastases have been very common in advanced cancer, which were observed in 30%-40% of cancer cases. Transarterial chemoembolization (TACE) is one of the choice for treating lung cancer. In our center, 119 cases of lung metastases were treated with TACE, and we found that inferior phrenic artery (IPA) played an important role in this procedure. Materials and Methods: From June 2011 to June 2015, 119 cases with malignant lung metastases received TACE procedure in our center...
January 2018: Journal of Cancer Research and Therapeutics
Jana Taron, Jonas Johannink, Michael Bitzer, Konstantin Nikolaou, Mike Notohamiprodjo, Rüdiger Hoffmann
BACKGROUND: To investigate the added diagnostic value of diffusion-weighted imaging (DWI) of the liver and its impact on therapy decisions in patients with hepatic malignancy. METHODS: Interdisciplinary gastrointestinal tumorboard cases concerning patients with hepatic malignancies discussed between 11/2015 and 06/2016 were included in this retrospective, single-center study. Two radiologists independently reviewed the respective liver MR-examination first without, then with DWI...
March 7, 2018: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Jennifer M Watchmaker, Andrew J Lipnik, Micah R Fritsche, Jennifer C Baker, Samdeep K Mouli, Sunil Geevarghese, Filip Banovac, Reed A Omary, Daniel B Brown
BACKGROUND AND OBJECTIVES: Prophylactic antibiotics are frequently administered for transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). In patients without previous biliary instrumentation, infection risk from TACE is low. We hypothesized that there is a negligible rate of infection in these patients without prophylactic antibiotics. METHODS: We reviewed consecutive patients undergoing TACE between 7/1/2013-6/15/2016. All patients had an intact Sphincter of Oddi, received no peri-procedural antibiotics, and had 30+ days follow-up...
March 7, 2018: Journal of Surgical Oncology
Martha M Kirstein, Torsten Voigtländer, Nora Schweitzer, Jan B Hinrichs, Jens Marquardt, Marcus-Alexander Wörns, Roman Kloeckner, Thorben W Fründt, Harald Ittrich, Frank Wacker, Thomas Rodt, Michael P Manns, Henning Wege, Arndt Weinmann, Arndt Vogel
Background: Sorafenib is the recommended treatment for advanced hepatocellular carcinoma (HCC), but transarterial chemoembolization (TACE) is performed in individual cases with limited extrahepatic spread. The aim of this study was to compare the outcome of patients with HCC and extrahepatic disease (EHD) treated with sorafenib and TACE. Methods: A total of 172 patients with HCC and EHD treated with sorafenib ( n  = 98) or TACE ( n  = 74) at three German referral centers (Hannover, Mainz and Hamburg) were included in this study...
March 2018: United European Gastroenterology Journal
Reem Waziry, Asmaa Gomaa, Imam Waked, Gregory J Dore
BACKGROUND AND STUDY AIMS: In this study we assessed rates and determinants of survival in people with untreated chronic HCV infection and hepatocellular carcinoma (HCC) in an Egyptian liver clinic setting. PATIENTS AND METHODS: This is a prospective cohort study of patients diagnosed with HCV-related HCC and undergoing HCC management at a national liver centre in Egypt in 2013-2014 and with a follow-up through 2016. RESULTS: A total of 345 patients diagnosed with HCV-related liver cirrhosis complicated by HCC were included...
March 2, 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Mohamed Awad Mansour, Mohamed Omar Khalifa
BACKGROUND AND STUDY AIMS: Transarterial chemoembolization remains a common treatment option in unresectable hepatocellular carcinoma. However, protocols for pre- and post-procedure care and the role of antibiotic prophylaxis have not been evaluated. The aim of this work was to compare 3 different groups of prophylactic antibiotics in patients undergoing chemoembolization and to compare the efficacy of intravenous versus oral route. PATIENTS AND METHODS: 180 hepatocellular carcinoma patients undergoing transarterial chemoembolization were selected...
March 1, 2018: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Erica S Alexander, Rosemarie Mick, Gregory J Nadolski, Jeffrey I Mondschein, S William Stavropoulos, Michael C Soulen
PURPOSE: The purpose of the study was to evaluate safety, time to recurrence, and overall survival (OS) in patients with liver metastases (LM), treated with transarterial chemoembolization (TACE) followed by ablation. MATERIALS AND METHODS: This retrospective study included all patients with LM treated with combined TACE and ablation from August 1998 to September 2015. Forty-two patients (12 women, 30 men; age 62.9 ± 11.9 years) were treated for 44 LMs. Tumor characteristics, imaging response to treatment, recurrence, and OS data were reviewed...
March 3, 2018: Abdominal Radiology
Xiao-Feng Zhai, Xiao-Lin Liu, Feng Shen, Jia Fan, Chang-Quan Ling
BACKGROUND: To explore the clinical efficacy of traditional herbal medicine (THM) in the prevention of disease recurrence of small hepatocellular carcinoma after surgery, a prospective randomized controlled study was conducted between October 2006 and May 2010. The results indicated that THM prevented the recurrence of SHCC with an efficacy that was superior to that of transarterial chemoembolization (TACE) during a median follow-up of 26.61 months. METHODS: The patients were followed up every 6 months, and the clinical data before October 20, 2015 were analyzed...
March 2, 2018: Cancer
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