Predictive factors for complete response of chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma

Abstract

• Literature on predictive factors of complete response after DEB-TACE is under-studied. • Tumour size <5 cm is associated with complete response. • Location in segments 1 or 4 is a pejorative factor for response. • No demographic parameter influences complete response.

Influence of pretreatment tumor growth rate on objective response of hepatocellular carcinoma treated with transarterial chemoembolization

“…Attention has been paid to technical aspects of TACE, and studies have shown that treatment selectivity, that is, the ability to catheterize and treat tumor feeders, improves response. [9][10][11][12][13] On the contrary, tumors located in segments I or IV 9 and hypoenhanced tumor or tumors associated with portal vein thrombosis (PVT) show lower response rate. 1 Tumor size smaller than 5 cm, lipiodol uptake during conventional chemoembolization, tumor hyperenhancement on hepatic arterial phase, and a limited number of tumors have also been shown to be associated with a good tumor response rate.…”

“…[6][7][8] Hence, recommendations state that selectivity should be reached whenever possible. 9,10,12,14,15 Patient characteristics have also been studied, 16 and several scoring systems have been proposed, combining various parameters to help predict the benefit of TACE or the need for re-TACE in previously treated patients. [9][10][11][12][13] On the contrary, tumors located in segments I or IV 9 and hypoenhanced tumor or tumors associated with portal vein thrombosis (PVT) show lower response rate.…”

“…1 Tumor size smaller than 5 cm, lipiodol uptake during conventional chemoembolization, tumor hyperenhancement on hepatic arterial phase, and a limited number of tumors have also been shown to be associated with a good tumor response rate. [9][10][11][12][13] On the contrary, tumors located in segments I or IV 9 and hypoenhanced tumor or tumors associated with portal vein thrombosis (PVT) show lower response rate. 9,10,12,14,15 Patient characteristics have also been studied, 16 and several scoring systems have been proposed, combining various parameters to help predict the benefit of TACE or the need for re-TACE in previously treated patients.…”

“…[9][10][11][12][13] On the contrary, tumors located in segments I or IV 9 and hypoenhanced tumor or tumors associated with portal vein thrombosis (PVT) show lower response rate. 9,10,12,14,15 Patient characteristics have also been studied, 16 and several scoring systems have been proposed, combining various parameters to help predict the benefit of TACE or the need for re-TACE in previously treated patients. [17][18][19] Despite promising initial results, these scores failed to withstand external validation and have not been widely adopted.…”

Balloon-Occluded Trans-Arterial Chemo-Embolization Technique with Repeated Alternate Infusion of Cisplatin Solution and Sparse Gelatin Slurry (RAIB-TACE) for Large Hepatocellular Carcinoma Nodules More than 7 cm in Diameter

“…Recently, the use of drug eluting beads was recommended rather than lipiodol to treat large nodules 5 cm or more [15]. However, when the diameter exceeded 5 cm, CR could be achieved in 13 of 74 nodules (17.6%) [16]. RAIB-TACE was superior to these TACE techniques to treat large nodules.…”