Segmental transcatheter arterial embolization for primary hepatocellular carcinoma

Abstract

AIM:To evaluate the therapeutic effects of segmental transcatheter arterial embolization for primary hepatocellular carcinoma, and to recognize the menifestation and clinical value of lipiodol overflow into portal veins surrounding the tumors.METHODS:A total of 50 cases of nonresectable primary hepatocellular carcinoma underwent segmental transcatheter arterial embolization. Two methods of superselective segmental catheterization were used, one was the method of wire-guiding, and the other the technic of co-axial infusion catheter.RESULTS:The 1-, 2-, 3- and 4-year cumulative survival rates of 50 cases with segmental transcatheter arterial embolization for primary hepatocellular carcinoma were 83.8%, 65.4%, 42.9% and 24.5% respectively. The in cidence of the lipiodol overflow into portal veins was 64%. The overflow of lipiodol intoportal veins, represented as 3-5 grade branches of portal veins visualized by lipiodol, was star-like or tree-like , and there was a relatively large vessel in the center surrounded with radicalized small branches of vessels.CONCLUSION:The lipiodol overflow into portal veins was one of the signs of complete embolization for tumors, and may play a partial role in embolizating the portal venous supply for hepatocellular carcinoma.

Combined transarterial chemoembolization and arterial administration ofBletilla striatain treatment of liver tumor in rats

“…Since TACE was introduced as a palliative treatment in patients with unresectable HCC, it has become one of the most common forms of interventional therapies [11,31] . TACE with iodized oil has been shown to result in regression of HCC and reduction of systemic toxicity, thus improving the therapeutic effects [21,32,33] .…”

“…Surgical resection, liver transplantation and cryosurgery are regarded as potentially curative treatment for HCC [3][4][5] , but most patients are not suitable candidates [6][7][8][9] . Thus, the local interventional therapy of liver tumor has been rapidly evolving currently, which includes transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI), radiofrequency ablation (RFA), laser-induced thermotherapy (LITT) and microwave coagulation therapy (MCT) [10][11][12][13][14][15][16][17][18][19] . TACE is one of the most common forms of interventional therapies and seems most effective against encapsulated small HCCs without extracapsular invasion, whereas in large HCCs, viable residual tumor cells remain and the tumor frequently recurs [20][21][22] .…”

Simultaneous Injection of Autologous Mononuclear Cells with TACE in HCC Patients; Preliminary Study

“…Surgical resection, liver transplantation, and cryosurgery are regarded as potentially curative treatment for HCC, but most patients are not suitable candidates [3]. Currently the local interventional therapy of liver tumor has been rapidly evolving, which includes transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI), radiofrequency ablation, laser-induced thermotherapy, and microwave coagulation therapy [4][5][6][7][8][9][10][11][12][13].…”

Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma: A cohort study

“…Recently, it has been demonstrated that TACE improves survival compared with best supportive care in meta-analyses of randomized trials [6,7] and in two individual clinical trials [8,9] . Nowadays TACE is often performed by selective catheterization of the hepatic segmental arteries nourishing the HCC lesions, to limit as much as possible the injury to the surrounding non tumorous liver as reported in previous studies [10][11][12] . However, although selective TACE is currently widely used, to our knowledge there are no reported extensive data from large series on both short and long term effects of this treatment on liver function.…”