Safety and Efficacy of Transcatheter Arterial Chemoemboliazation in the Real-Life Management of Unresectable Hepatocellular Carcinoma

Mazioti, Argyro; Gatselis, Nikolaos; Rountas, Christos; Zachou, Kalliopi; Filippiadis, Dimitrios; Tepetes, K.; Koukoulis, George Κ.; Fezoulidis, Ioannis; Dalekos, George Ν.

doi:10.5812/hepatmon.7070

Cited by 8 publications

(11 citation statements)

References 22 publications

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“…Taken together, these results indicate that the WBC count increased after TACE in the majority of the patients, which was consistent with the findings of Mazioti et al (18). For the 3 patients who developed agranulocytosis following TACE, the WBC count increased after treatment with G-CSF and returned to the preprocedural level at 30 days after TACE.…”

Section: Resultssupporting

confidence: 81%

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Perioperative safety analysis of transcatheter arterial chemoembolization for hepatocellular carcinoma patients with preprocedural leukopenia or thrombocytopenia

Zhou

Zhang

Wang

et al. 2017

Molecular and Clinical Oncology

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Abstract.Patients with hepatocellular carcinoma (HCC) exhibit a high incidence of concomitant cirrhosis with leukopenia and/or thrombocytopenia. In the present study, perioperative changes in the white blood cell (WBC) and platelet (PLT) counts and associated complications were investigated to assess the safety of transcatheter arterial chemoembolization (TACE) for HCC patients with preprocedural leukopenia or thrombocytopenia. The records of 1,461 HCC patients who received TACE between January 2012 and December 2013 were retrospectively reviewed. The incidence of complications during the perioperative period and changes in the WBC and PLT counts were recorded. A Chi -squared test was used to evaluate the associations between postoperative infection and preprocedural WBC count and between bleeding at the puncture site and preprocedural PLT count. The WBC count of the majority of the patients increased within 3 days and returned to the preprocedural level within 30 days after TACE. The PLT count decreased within 3 days and returned to the preprocedural level within 30 days after TACE. The major complications were liver decompensation (n=66), puncture site bleeding (n=45), infection (n=33), severe thrombocytopenia (n=8), upper gastrointestinal bleeding (n=6), tumor bleeding (n=4) and agranulocytosis (n=3). A Chi-squared test revealed that postoperative infection was not associated with preprocedural WBC count and puncture site bleeding was not associated with decreased PLT count due to hypersplenism. Therefore, TACE was found to be safe for HCC patients with preprocedural thrombocytopenia or leukopenia due to hypersplenism, with a low incidence of major complications during the perioperative period.

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Section: Resultssupporting

confidence: 81%

“…A total of 8 patients developed severe thrombocytopenia following TACE, and their PLT counts returned to normal after IL-11 treatment. The PLT count declined at 3 days after TACE in the majority of the patients, consistent with the findings of Mazioti et al (18), but returned to the preprocedural level at 30 days after TACE.…”

Section: Resultssupporting

confidence: 79%

Perioperative safety analysis of transcatheter arterial chemoembolization for hepatocellular carcinoma patients with preprocedural leukopenia or thrombocytopenia

Zhou

Zhang

Wang

et al. 2017

Molecular and Clinical Oncology

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“…The incidence in non-cirrhotic HBV infected patients is less than 4%. This is in contrast to a lower incidence (1.4%) in HCV patients [4][5][6][7] . Prompt diagnosis of early or very early stage HCC is difficult due to the lack of specific symptoms and the relatively limited prognostic value of the serological and radiological approaches currently used for surveillance.…”

Section: Introductionmentioning

confidence: 47%

“…The major causes of HCC are hepatitis B virus (HBV)-or hepatitis C virus (HCV)-related cirrhosis and alcoholic cirrhosis [1][2][3][4][5] . In Greece, data from the HEPNET-GREECE Study Group has shown a cumulative 5-year incidence of HCC approaching 20% in decompensated and 10% in compensated patients with HBV-related cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Cartilage oligomeric matrix protein: A novel non-invasive marker for assessing cirrhosis and risk of hepatocellular carcinoma

Norman¹

2015

WJH

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AIM:To assess serum cartilage oligomeric matrix protein (COMP) as a marker of cirrhosis and risk of progression to hepatocellular carcinoma (HCC). METHODS: A COMP enzyme-linked immunosorbent ORIGINAL ARTICLEassay was used to test 187 patients with chronic liver diseases at the time point of first evaluation. The selected patients included 72 with chronic hepatitis B infection, 75 with chronic hepatitis C infection, 22 with primary biliary cirrhosis, 7 with autoimmune hepatitis type 1, and 11 with alcoholic liver disease. Demographic, biochemical, histological and clinical characteristics of the patients were recorded at the first evaluation. One hundred and forty-seven patients were followed for a median [interquartile range (IQR)] duration of 96.5 (102) mo. The clinical, biochemical and histological data, as well as the development of cirrhosis, HCC according to internationally accepted criteria and in case of death, a liver-related cause during the follow-up period, were recorded at the electronic database of our clinic. COMP determination was also performed in 43 healthy individuals who served as the control study group. RESULTS:COMP positivity (> 15 U/L) was detected in 22%-36% among chronic liver disease groups. Strikingly, almost 83% of COMP-positive patients were cirrhotic at baseline, independently of cause of liver disease. Among the patients who developed HCC during follow-up, 73.7% (14/19) were COMP positive at baseline. COMP positivity was significantly associated with older age (P < 0.001), advanced fibrosis (P = 0.001) and necroinflammatory activity (P = 0.001), higher aspartate aminotransferase (P < 0.001), alanine aminotransferase (P < 0.02), γ-glutamyl transpeptidase (P = 0.003), alkaline phosphatase (P = 0.001), bilirubin (P < 0.05), international normalized ratio (P = 0.002) and alpha-fetoprotein levels (P < 0.02), and lower albumin (P < 0.001), and platelet count (P = 0.008). COMP levels [median (IQR)] were significantly higher in cirrhotics compared to non-cirrhotics [13.8 (7.9) U/L vs 9.8 (4.6) U/L, respectively; P < 0.001]. On multivariate logistic regression analysis, COMP-positivity was independently associated only with cirrhosis (OR = 4.40, 95%CI: 1.33-14.69, P = 0.015). Kaplan-Meier analysis showed that COMP positivity was significantly associated with HCC development (P = 0.007) and higher incidence of liver-related death (P < 0.001).CONCLUSION: Elevated COMP levels are strongly associated with cirrhosis and HCC progression. Serum COMP is a new promising non-invasive biomarker for HCC risk assessment in surveillance programs.

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“…TACE is also associated with a promising survival benefit for patients with well-preserved liver function (11). Preoperative TACE was reported to minimize surgical morbidity and mortality and improve overall survival after curative liver resection in selected HCC patients with major vascular invasion (12).…”

mentioning

confidence: 99%

Neoadjuvant Transcatheter Arterial Chemoembolization for Biliary Tumor Thrombosis: A Retrospective Study

Shen

Pang

Cui

et al. 2016

Int J Technol Assess Health Care

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Objectives: Curative hepatectomy and tumor thrombectomy for hepatocellular carcinoma with complicating biliary tumor thrombosis (HCC/BTT) is associated with high surgical morbidity and mortality. This retrospective study evaluated the effectiveness and safety of neoadjuvant transcatheter arterial chemoembolization (TACE) in HCC/BTT patients scheduled for curative resection. Methods: Thirty consecutive patients with diagnosed HCC/BTT were hospitalized for neoadjuvant TACE and elective curative liver resection (group A; n = 20) or curative liver resection alone (group B; n = 10). The primary outcome measure was median survival. Results: Group A had a significantly shorter overall operative time (160 ± 25 versus 190 ± 35 min; p < .01) and duration of inflow control (14.3 ± 3.6 versus 25.1 ± 5.1 min; p < .01) and significantly less intraoperative blood loss (150 ± 35 versus 520 ± 75 ml; p < .01) and transfusion (100 ± 40 versus 375 ± 55 ml; p < .01) as compared to group B. Among patients undergoing both thrombectomy and curative resection, the median survival of group A was significantly longer than that of group B (28.5 [9-54] versus 21.5 [6-39] months; p < .01); among those who received thrombectomy alone, the median survival of group A was also significantly longer than that of group B (12.8 [6-25] versus 4.5 [2-7] months; p < .01). Conclusions: Neoadjuvant TACE significantly reduced the surgical risk of curative liver resection and significantly prolonged median survival in HCC patients with complicating BTT.

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Safety and Efficacy of Transcatheter Arterial Chemoemboliazation in the Real-Life Management of Unresectable Hepatocellular Carcinoma

Cited by 8 publications

References 22 publications

Perioperative safety analysis of transcatheter arterial chemoembolization for hepatocellular carcinoma patients with preprocedural leukopenia or thrombocytopenia

Perioperative safety analysis of transcatheter arterial chemoembolization for hepatocellular carcinoma patients with preprocedural leukopenia or thrombocytopenia

Cartilage oligomeric matrix protein: A novel non-invasive marker for assessing cirrhosis and risk of hepatocellular carcinoma

Neoadjuvant Transcatheter Arterial Chemoembolization for Biliary Tumor Thrombosis: A Retrospective Study

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