Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis?

Yamakado, Koichiro; Miyayama, Shiro; Hirota, Shun; Mizunuma, Kimiyoshi; Nakamura, Kenji; Inaba, Yoshitaka; Maeda, Akihiro; Matsuo, Keitaro; Nishida, Norifumi; Aramaki, Takeshi; Anai, Hiroshi; Koura, Shin-ichi; Oikawa, Shoko; Watanabe, Ken; Yasumoto, Taku; Furuichi, Kinya; Yamaguchi, Masato

doi:10.1007/s11604-012-0088-1

Cited by 70 publications

(43 citation statements)

References 28 publications

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“…Conventional transarterial chemoembolization techniques also have an impact on patient survival. In patients with HCC r 7 cm and five or fewer lesions, the prognosis of patients who underwent selective/superselective conventional transarterial chemoembolization was significantly more favorable than the prognosis of patients who underwent nonselective (lobar) conventional transarterial chemoembolization (P = .033) (44). These studies suggest that superselective conventional transarterial chemoembolization is indicated for patients with Child-Pugh scores of 5-8 and HCC r 7 cm and five or fewer lesions.…”

Section: Indication For Superselective Conventional Transarterial Chementioning

confidence: 81%

Superselective Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma: Rationale, Technique, and Outcome

Miyayama

Matsui

2016

Journal of Vascular and Interventional Radiology

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Section: Indication For Superselective Conventional Transarterial Chementioning

confidence: 81%

Superselective Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma: Rationale, Technique, and Outcome

Miyayama

Matsui

2016

Journal of Vascular and Interventional Radiology

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“…By contrast, in patients with substage B2 HCC, the liver function after the third and fifth TACE sessions deteriorated compared with that after the first TACE session. As the liver function is impaired by TACE, it is recommended to perform TACE as selectively as possible [11,37,38] . However, it is difficult to perform TACE selectively, especially for multiple HCCs, and TACE could also affect the normal liver and, consequently, impair the liver function.…”

Section: Discussionmentioning

confidence: 99%

Time to Transcatheter Arterial Chemoembolization Refractoriness in Patients with Hepatocellular Carcinoma in Kinki Criteria Stages B1 and B2

Arizumi

Minami²,

Chishina³

et al. 2017

Dig Dis

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Background: Transarterial chemoembolization (TACE) is recommended for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage B. However, because of the heterogeneity of HCC in BCLC stage B; various subclassification systems have been proposed to predict the prognosis of patients. Previously, we proposed the Kinki criteria for precise classification of HCC cases in BCLC stage B. In this study, we compared the time to TACE refractoriness in HCC patients with Kinki criteria substages B1 and B2-HCC. Summary: Between January 2006 and December 2013, 592 HCC patients (substage B1, n = 118; substage B2, n = 170) underwent TACE. Time to progression under TACE treatment was defined as the time to untreatable progression (TTUP). TTUP and changes in liver function were analyzed in patients with substages B1 and B2-HCC.The median TTUP was 25.7 months (95% CI 19.3-37.3) and 16.4 months (95% CI 13.1-20.2) in patients with substage B1-HCC and substage B2-HCC, respectively (p = 0.0050). In patients with substage B2-HCC, median Child-Pugh scores after the first TACE session was significantly different from those after third and fifth TACE sessions (first-third, p = 0.0020; first-fifth, p = 0.0008). Key Message: TACE refractoriness occurred earlier in patients with substage B2-HCC than those with substage B1-HCC; deterioration of liver function with repeated TACE was more obvious in HCC cases with stage-B1 tumor. Shorter TTUP and impaired liver function due to repeated TACE could be responsible for the shorter survival in patients with substage B2-HCC.

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“…On multivariate analysis, selective TACE, the AFP level at the time of the first TACE, and radiologic tumor response were useful prognostic factors for predicting OS. Therefore, it is conceivable that performing selective TACE, which is commonly applied in Japan, leads to prolonged OS in our cohort [32]. …”

Section: Discussionmentioning

confidence: 99%

Evaluation of ART Scores for Repeated Transarterial Chemoembolization in Japanese Patients with Hepatocellular Carcinoma

et al. 2015

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Objective: Transarterial chemoembolization (TACE) is recommended as a first-line therapy for hepatocellular carcinoma (HCC) patients ineligible for curative therapy and without portal invasion. The Assessment for Retreatment with TACE (ART) scoring system was recently proposed for identifying patients who would not show sufficient survival benefit from repeated TACE. We reevaluated the performance of ART in HCC patients treated in Japan, where selective TACE is commonly used. Methods: Between 2000 and 2013, 988 patients with HCC underwent TACE at Kinki University Hospital, and 627 received ≥2 sessions of TACE. Seventy-six patients who underwent ≥2 TACE sessions within 90 days were investigated for their performance of the ART score in the context of overall survival (OS). Results: Only 12% (76/627) of patients underwent ≥2 TACE sessions within 90 days. Of those, 52 patients showed a low ART score (0-1.5), and 24 had a high ART score (≥2.5); the median OS was 20.2 and 37.6 months, respectively (p = 0.8207). Conclusion: The ART scoring system did not demonstrate a sufficiently predictive impact on OS among the patients who underwent ≥2 TACE sessions within 90 days. Application of the ART score should be carefully considered because differences in TACE procedures and post-TACE treatment can affect the results while evaluating OS.

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Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis?

Abstract: Selective embolization contributes to survival in patients with HCCs.

Cited by 70 publications

References 28 publications

Superselective Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma: Rationale, Technique, and Outcome

Superselective Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma: Rationale, Technique, and Outcome

Time to Transcatheter Arterial Chemoembolization Refractoriness in Patients with Hepatocellular Carcinoma in Kinki Criteria Stages B1 and B2

Evaluation of ART Scores for Repeated Transarterial Chemoembolization in Japanese Patients with Hepatocellular Carcinoma

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