Gelatin sponge microparticles for the treatment of the spontaneous rupture of hepatocellular carcinoma hemorrhage

Abstract

Spontaneous rupture of hepatocellular carcinoma hemorrhage is life-threatening. The aim of the present study was to retrospectively analyze the effect of gelatin sponge microparticles (GSMs) of various diameters on the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSMs serve as embolization agents by transcatheter arterial chemoembolization (TACE), and the current study analyzed their safety and efficacy. Data from a total of 13 cases of spontaneous rupture of hepatocellular carcinoma hemorrhage, who were treated with GSM-TACE at the Affiliated Zhongshan Hospital of Dalian University (Dalian, China) between August 2010 and June 2014, were collected. Post-operative complications were classified according to the National Cancer Institute Common Terminology Criteria. Review computed tomography was conducted 1, 3 and 6 months after GSM-TACE treatment in order to determine the occurrence of re-bleeding; the tumor response was evaluated based on the Modified Response Evaluation Criteria In Solid Tumors and the expression levels of α-feroprotein. The patients were followed-up for 1-6 months (average, 5.15±1.67 months). Following GSM-TACE treatment, 13 cases reached successful hemostasis without technical complications. The survival rates 1, 3 and 6 months after treatment were 76.9 (10/13), 61.5 (8/13) and 53.8% (7/13), respectively; the objective response rates were 61.6, 53.9 and 38.5%, respectively. The primary post-operative complications were pain (100%), nausea and vomiting (69.2%), and fever (53.8%). Among the 13 patients, 2 cases underwent surgical excision 10 and 30 days after GSM-TACE, and 1 case experienced re-bleeding 3 months after treatment, after which the patient received a second treatment with TACE and successful achieved hemostasis. In conclusion, GSM-TACE of various diameters is a safe and effective method in the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSM-TACE is able to achieve immediate hemostasis and improves the survival rate of patients, thus creating favorable conditions for follow-up treatment.

Management, outcomes, and prognostic factors of ruptured hepatocellular carcinoma: A systematic review

“…Searching the reference list (snowball procedure) retrieved two additional articles. In total, 67 studies were deemed eligible and therefore included in the systematic review …”

“…The mean age of the study population was 55.6 years (SD = 6.64) with most patients being male (77.9%). A large portion of the cohort population consisted of patients from Asia, as 22 studies (33%) were from China, 17 (25%) from Japan, 10 (15%) from Taiwan, 5 (7.5%) from Korea, 2 (3%) from Thailand, and 1 (1.5%) each from Singapore and Malaysia . In contrast, studies about rHCC were less common from Western centers with only 2 reports (3%) from the Netherlands and Italy, and 1 (1.5%) each from Canada, France, United Kingdom, USA, and Nigeria .…”

“…Thirty‐five studies provided data on short‐term survival (Table ) . The leading causes of death in the short‐term was demise either from bleeding complications (34.3%) or hepatic failure (30.0%).…”

Modeling pre-metastatic lymphvascular niche in the mouse ear sponge assay

“…It is worth mentioning that the biomaterial used in our model has been previously used with other purposes. For instance, small pieces of gelatin sponges have been inserted in a rabbit liver tumor model of hepatic arterial chemoembolization 18 or have been used as embolization agents for the treatment of the spontaneous rupture in hepatocellular carcinoma hemorrhage 19 . Other types of tumor or non-tumor cell encapsulation have been already used.…”

New modalities of treatment for hepatocellular carcinoma

“…Gelatin sponge micro particles (GSMs) have medium effect. 29 Using the embolization component in TACE procedure increases the rate of necrosis of the main tumour and Gelatine sponge particles is used frequently in embolization procedures. 30 Gelatin sponge microparticles in a rabbit liver tumour were assessed in 2014.…”