Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Single-Center Experience

Abstract

Objective: To investigate whether balloon-occluded transcatheter arterial chemoembolization (b-TACE) can produce a more dense accumulation of iodized oil in various stages of hepatocellular carcinoma (HCC), from single to uncountable, to overcome inferior local control. Materials and Methods: We studied 27 patients with HCC, including single to uncountable multiple lesions, who underwent b-TACE between August 2013 and April 2015. Dynamic CT was performed at baseline and 1-3 months after b-TACE. The treatment effect (TE) after b-TACE was evaluated using the Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan. Results: In the countable HCC group, contrast-enhanced CT demonstrated RECICL TE4 in 43.8% (14/32), TE3 in 12.5% (4/32), TE2 in 37.5% (12/32), and TE1 in 6.3% (2/32) of patients. For the TACE-naïve cohort, the objective response rate was 52.9%. The objective response rate was 60% for the previously TACE-treated cohort. In the uncountable multiple HCC group, the objective response rate was 0% (0/10), with progressive disease in 90% (9/10) of patients. Conclusion: Our observations suggested that b-TACE did not reduce the efficacy of retreatment for HCC with an insufficient outcome from conventional TACE, but it could not improve the efficacy of treatment for uncountable multiple HCCs.

Outcomes of metastatic spinal cord compression secondary to primary hepatocellular carcinoma with multidisciplinary treatments

“…Although TACE is regarded as an alternative therapy of surgical resection for advanced HCCs, it didn't seem to prolong PFS or OS as shown in our study. A recent relevant study [48] also suggested that TACE didn't improve the efficacy of treatment for advanced HCCs, and therefore it was not recommended for use in combination with other therapies [49]. In our study, we found that patients who underwent hepatecotomy with or without liver transplantation tended to have a better OS ( p = 0.006).…”

Hepatic Function during Repeated TACE Procedures and Prognosis after Introducing Sorafenib in Patients with Unresectable Hepatocellular Carcinoma: Multicenter Analysis

“…First, even though results of imaging findings were matched to the Japanese definition of TACErefractory, clinicians judged the therapeutic response as SD. It is also possible that some clinicians want to re-try TACE by changing chemo-agents, embolization particles, or catheter devices, such as beads [30,31] or a balloon catheter [32,33] . Even after excluding patients who no longer continued with TACE because of worsening hepatic function or progression of HCC, the present findings showed that repeated TACE procedures made hepatic function worse at a fixed frequency, while the deviation rate for worsened grade according to an increased number of TACE procedures was larger when patients were assessed using ALBI-grade rather than Child-Pugh classification.…”

The Overall Survival of Patients with Hepatocellular Carcinoma Correlates with the Newly Defined Time to Progression after Transarterial Chemoembolization

“…It is noteworthy that the establishment of a nationwide HCC surveillance program contributed to improved overall survival (OS) rates [2] . With respect to treatment, sorafenib is effective for cases of advanced HCC [3,4] , and various embolic materials and catheters have been developed for transarterial chemoembolization (TACE) [5] . These advances have contributed to improved OS rates in the past decade.…”