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transarterial chemoembolisation

Sai Pavan Chintalapati, Arpan Patel, Hari Conjeevaram
Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. A 64-year-old man presented with chronic hepatitis C cirrhosis and multifocal bilobar HCC. He had previously undergone multiple TACE sessions, radiofrequency ablation and stereotactic body radiation therapy. In the evening of his TACE procedure, he developed abdominal pain and haematemesis...
February 21, 2018: BMJ Case Reports
Tim Sattler, Christina Bredt, Stefanie Surwald, Christian Rust, Johannes Rieger, Tobias Jakobs
BACKGROUND/AIM: To retrospectively evaluate the efficacy and safety of drug eluting bead (DEB) transarterial chemoembolisation (TACE) with microspheres <150 μm for the treatment of hepatocellular carcinoma (HCC) with respect to overall survival, progression-free survival, tumor response and the peri-interventional toxicity. MATERIALS AND METHODS: In this retrospective, single-center study we analyzed 32 HCC-patients (BCLC A: 10 patients, BCLC B: 17 patients, BCLC C: 5 patients), who were treated with (DEB) <15 μm (DCBeadM1®) loaded with epirubicin between 2011 and 2015...
February 2018: Anticancer Research
Sarah Degiorgio, Roberta Gerasia, Ferdinanda Liotta, Luigi Maruzzelli, Kelvin Cortis, Roberto Miraglia, Angelo Luca
PURPOSE: The primary aim of this study is to provide a summary of operators' radiation doses during hepatobiliary fluoroscopic guided procedures. In addition, patient dose in these procedures was also documented. MATERIALS AND METHODS: A total of 283 transarterial chemoembolisation (TACE) and 302 biliary procedures, including 52 percutaneous transhepatic cholangiogram (PTC), 36 bilioplasty and 214 biliary catheter changes (BCC) performed over 14 months, were included...
January 17, 2018: Cardiovascular and Interventional Radiology
Valérie Vilgrain, Helena Pereira, Eric Assenat, Boris Guiu, Alina Diana Ilonca, Georges-Philippe Pageaux, Annie Sibert, Mohamed Bouattour, Rachida Lebtahi, Wassim Allaham, Hélène Barraud, Valérie Laurent, Elodie Mathias, Jean-Pierre Bronowicki, Jean-Pierre Tasu, Rémy Perdrisot, Christine Silvain, René Gerolami, Olivier Mundler, Jean-Francois Seitz, Vincent Vidal, Christophe Aubé, Frédéric Oberti, Olivier Couturier, Isabelle Brenot-Rossi, Jean-Luc Raoul, Anthony Sarran, Charlotte Costentin, Emmanuel Itti, Alain Luciani, René Adam, Maïté Lewin, Didier Samuel, Maxime Ronot, Aurelia Dinut, Laurent Castera, Gilles Chatellier
BACKGROUND: Sorafenib is the recommended treatment for patients with advanced hepatocellular carcinoma. We aimed to compare the efficacy and safety of sorafenib to that of selective internal radiotherapy (SIRT) with yttrium-90 (90 Y) resin microspheres in patients with hepatocellular carcinoma. METHODS: SARAH was a multicentre, open-label, randomised, controlled, investigator-initiated, phase 3 trial done at 25 centres specialising in liver diseases in France. Patients were eligible if they were aged at least 18 years with a life expectancy greater than 3 months, had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, Child-Pugh liver function class A or B score of 7 or lower, and locally advanced hepatocellular carcinoma (Barcelona Clinic Liver Cancer [BCLC] stage C), or new hepatocellular carcinoma not eligible for surgical resection, liver transplantation, or thermal ablation after a previously cured hepatocellular carcinoma (cured by surgery or thermoablative therapy), or hepatocellular carcinoma with two unsuccessful rounds of transarterial chemoembolisation...
December 2017: Lancet Oncology
Georg P Györi, D Moritz Felsenreich, Gerd R Silberhumer, Thomas Soliman, Gabriela A Berlakovich
Background: It is current practice that patients with hepatocellular carcinoma (HCC) listed for liver transplantation should receive locoregional treatment if the suspected waiting time for transplantation is longer than 6 months, even in the absence of prospective randomized data. Aim of this study was the comparison of single versus multimodality locoregional treatment strategies on outcomes after liver transplantation. Methods: This is a retrospective analysis of 150 HCC patients listed for liver transplantation at our center between 2004 and 2011...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
T Tang, J-L Qiu, G-W Li, M-P Huang, Y Li, Y-J Li, S-Z Gu
AIM: To evaluate the value of the aspartate aminotransferase-to-platelet ratio index (APRI) for hepatocellular carcinoma (HCC) patients who underwent transarterial chemoembolisation (TACE). MATERIALS AND METHODS: A total of 315 patients were enrolled, who were randomly divided into the training cohort (n=158) and the validation cohort (n=157). The optimal cut-off value of the APRI was determined using the X-tile software in the training cohort, and was validated in the validation cohort...
October 12, 2017: Clinical Radiology
Nils Rathmann, Kerim Kara, Johannes Budjan, Thomas Henzler, Arman Smakic, Stefan O Schoenberg, Steffen J Diehl
AIM: Prospective comparison of cone beam C-Arm CT based parenchymal liver blood volume (PLBV) and dynamic volume perfusion CT (dVPCT) measurements in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolisation (TACE) with drug-eluting beads (DEB). PATIENTS AND METHODS: In 16 patients, changes of PLBV and dVPCT measurements [arterial liver parenchyma (ALP); temporal maximum intensity projection (MIP); hepatic perfusion index (HPI); portal venous parenchyma] were correlated to one another and to the modified Response Evaluation Criteria in Solid Tumors (mRECIST)...
October 2017: Anticancer Research
Mengchuan Wang, Jian Zhang, Shufeng Ji, Guoli Shao, Kankan Zhao, Zixiang Wang, Aiguo Wu
BACKGROUND: There is limited data on the impact of transarterial chemoembolisation (TACE) on survival in patients of breast cancer with liver metastasis (BCLM). METHODS: A systematic review was conducted to assess TACE effect on BCLM patients. A search for clinical studies published since 1/1/2000 to 1/1/2017 was performed. Survival data from all studies were extracted to evaluate the efficacy of TACE, including overall survival, disease free survival and response rate...
December 2017: Breast: Official Journal of the European Society of Mastology
S S Kim, T W Kang, M Kim, M W Lee, S K Cho, Y H Paik, M-J Kim
AIM: To compare the long-term therapeutic outcomes of repeated radiofrequency ablation (RFA) with that of transarterial chemoembolisation (TACE) in patients with local tumour progression (LTP) after initial RFA treatment for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: This retrospective study was approved by the institutional review board and the requirement for informed consent was waived. Between July 2006 and February 2012, 713 patients underwent RFA for single HCC as a first-line treatment...
February 2018: Clinical Radiology
Eric A Wang, Jeff P Stein, Ross J Bellavia, Scott R Broadwell
Hepatocellular carcinoma (HCC), the predominant form of primary liver cancer, is the second leading cause of cancer-related deaths across the globe. Only a small percentage of HCC patients (~20%-30%) are diagnosed at an early stage when first-line treatment options may be effective. The majority of HCC patients (>70%) are diagnosed with unresectable disease and given a poor overall prognosis. Current treatment guidelines recommend locoregional therapy with transarterial chemoembolisation (TACE) and systemic therapy with sorafenib as first-line treatment for patients with intermediate and advanced stage HCC...
July 30, 2017: International Journal of Clinical Practice
Elisabeth G Klompenhouwer, Raphaëla C Dresen, Chris Verslype, Annouschka Laenen, Gert De Hertogh, Christophe M Deroose, Lawrence Bonne, Vincent Vandevaveye, Geert Maleux
INTRODUCTION: Transarterial chemoembolisation (TACE) is the most widely used locoregional treatment for patients with an unresectable hepatocellular carcinoma (HCC). Transarterial radioembolisation (TARE) with yttrium-90 containing microspheres is an emerging interventional treatment that could be complementary or an alternative to TACE. AIM: To evaluate the safety and efficacy of TARE in patients with HCC who are refractory to TACE with drug-eluting beads (DEB-TACE)...
July 6, 2017: Cardiovascular and Interventional Radiology
Duc Do Minh, Julius Chapiro, Boris Gorodetski, Qiang Huang, Cuihong Liu, Susanne Smolka, Lynn Jeanette Savic, David Wainstejn, MingDe Lin, Todd Schlachter, Bernhard Gebauer, Jean-François Geschwind
OBJECTIVES: To compare efficacy, survival outcome and prognostic factors of conventional transarterial chemoembolisation (cTACE), drug-eluting beads TACE (DEB-TACE) and yttrium-90 radioembolisation (Y90) for the treatment of liver metastases from gastroenteropancreatic (GEP) neuroendocrine tumours (NELM). METHODS: This retrospective analysis included 192 patients (58.6 years mean age, 56% men) with NELM treated with cTACE (N = 122), DEB-TACE (N = 26) or Y90 (N = 44) between 2000 and 2014...
December 2017: European Radiology
Tim Meyer, Richard Fox, Yuk Ting Ma, Paul J Ross, Martin W James, Richard Sturgess, Clive Stubbs, Deborah D Stocken, Lucy Wall, Anthony Watkinson, Nigel Hacking, T R Jeffry Evans, Peter Collins, Richard A Hubner, David Cunningham, John Neil Primrose, Philip J Johnson, Daniel H Palmer
BACKGROUND: Transarterial chemoembolisation (TACE) is the standard of care for patients with intermediate stage hepatocellular carcinoma, while the multikinase inhibitor sorafenib improves survival in patients with advanced disease. We aimed to determine whether TACE with sorafenib improves progression-free survival versus TACE with placebo. METHODS: We did a multicentre, randomised, placebo-controlled, phase 3 trial (TACE 2) in 20 hospitals in the UK for patients with unresectable, liver-confined hepatocellular carcinoma...
June 22, 2017: Lancet. Gastroenterology & Hepatology
Jing Zhao, Dapeng Li, Yue Shi, Fengling Shi, Chengting Feng, Wei Li, Min Tao, Rongrui Liang
INTRODUCTION: The purpose of this meta-analysis was to compare the efficacy of transarterial chemoembolisation (TACE) and iodised oil infusion chemotherapy without embolisation (TAI) in patients with hepatocellular carcinoma. MATERIALS AND METHODS: We searched for randomised controlled trials, retrospective cohort studies, and two-arm prospective studies that compared the clinical outcomes in patients who received TACE and TAI treatment. Database search was performed through 14 December 2016...
May 2017: Annals of the Academy of Medicine, Singapore
Bo-Ching Lee, Kao-Lang Liu, Cheng-Li Lin, Chia-Hung Kao
OBJECTIVE: This nationwide population-based cohort study evaluated the association between acute kidney injury (AKI) and transarterial chemoembolisation (TACE) in patients with hepatocellular carcinoma (HCC). METHODS: The case cohort included patients with HCC who had undergone TACE treatment between 1 January 1998 and 31 March 2010. Patients with baseline chronic kidney disease, with baseline end-stage renal disease, and aged younger than 20 years were excluded...
November 2017: European Radiology
Y Asayama, D Okamoto, Y Ushijima, A Nishie, K Ishigami, Y Takayama, N Fujita, H Honda
AIMS: To identify predictors of a therapeutic effect after transarterial chemoembolisation using drug-eluting beads (DEB-TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Between January 2015 and July 2015, tumour variables and angiographic data were collected for 25 patients (49 target lesions) after they had undergone the DEB-TACE procedure for HCC. The therapeutic effect was evaluated according to the Response Evaluation Criteria in Cancer of the Liver at follow-up dynamic computed tomography (CT) performed within 1-4 months after the procedure...
September 2017: Clinical Radiology
Huan Tong, Bo Wei, Shuang Chen, Yong-Mei Xie, Ming-Guang Zhang, Lin-Hao Zhang, Zhi-Yin Huang, Cheng-Wei Tang
Recurrence of hepatocellular carcinoma (HCC) after transarterial chemoembolisation (TACE) is common due to neoangiogenesis. Cyclooxygenase-2 inhibitors and somatostatin analogues were reported to inhibit tumour angiogenesis. The pilot randomized controlled trial was aimed to prospectively evaluate the protocol of TACE combined with celecoxib and lanreotide (TACE+C+L) in patients with unresectable and advanced HCC. A total of 71 patients with HCC were enrolled and randomly assigned to either TACE (n=35) or TACE+C+L (n=36) group...
July 18, 2017: Oncotarget
Claire L Stevens, Andrew Awad, Saleh M Abbas, David A K Watters
BACKGROUND: Surgical techniques and pre-operative patient evaluation have improved since the initial development of the Barcelona clinic liver cancer staging system. The optimal treatment for solitary hepatocellular carcinoma ≥5 cm remains unclear. The aim of this study was to review the long-term survival outcomes of hepatic resection versus transarterial chemoembolisation (TACE) for solitary large tumours. METHODS: EMBASE, MEDLINE, Pubmed and the Cochrane database were searched for studies comparing resection with TACE for solitary HCC ≥5 cm...
April 17, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Avik Majumdar, Davide Roccarina, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Hepatocellular carcinoma (primary liver cancer) is classified in many ways. The Barcelona Clinic Liver Cancer (BCLC) group staging classifies the cancer based on patient's life expectancy. People with very early- or early-stage hepatocellular carcinoma have single tumour or three tumours of maximum diameter of 3 cm or less, Child-Pugh status A to B, and performance status 0 (fully functional). Management of hepatocellular carcinoma is uncertain. OBJECTIVES: To assess the comparative benefits and harms of different interventions used in the treatment of early or very early hepatocellular carcinoma through a network meta-analysis and to generate rankings of the available interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
Davide Roccarina, Avik Majumdar, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: There is significant uncertainty in the treatment of intermediate-stage hepatocellular carcinoma which is defined by the Barcelona Clinic Liver Cancer (BCLC) as hepatocellular carcinoma stage B with large, multi-nodular, Child-Pugh status A to B, performance status 0 to 2, and without vascular occlusion or extrahepatic disease. OBJECTIVES: To assess the comparative benefits and harms of different interventions used in the treatment of intermediate-stage hepatocellular carcinoma (BCLC stage B) through a network meta-analysis and to generate rankings of the available interventions according to their safety and efficacy...
March 10, 2017: Cochrane Database of Systematic Reviews
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