Survival and Outcome in Patients Receiving Drug-Eluting Beads Transarterial Chemoembolization for Large Hepatocellular Carcinoma (&gt;5 cm)

Mukund, Amar; Bhardwaj, Krishna; Choudhury, Ashok; Sarin, Shiv Kumar

doi:10.1016/j.jceh.2021.02.003

Cited by 9 publications

(3 citation statements)

References 19 publications

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“…Further studies have shown that an increase in tumor diameter is significantly associated with a poorer survival [ 47 ]. On the other hand, Mukund et al recently showed that patients with extensive lesions (>5 cm) could also be successfully treated with TACE, improving their overall survival [ 48 ]. This does not contradict that increasing lesion size has an impact on the overall survival, as patient selection and specific patient characteristics confounded the excellent survival of this cohort of patients with extensive lesions.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Cohort Analysis of Transarterial Chemoembolization for Hepatocellular Cancer at a Tertiary Center in Switzerland

Haak,

Karli,

Takes

et al. 2024

JCM

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Background/Objectives: International guidelines recommend transarterial chemoembolization (TACE) for intermediate-stage hepatocellular carcinoma (HCC). However, it is used outside these recommendations and has proven beneficial in prolonging survival. Since the role of TACE outside BCLC stage B is unclear, the present study analyzed the results of TACE performed at a tertiary center in Switzerland for different treatment groups, and aims to highlight the treatment outcomes for these groups. Methods: This retrospective cohort study includes 101 HCC patients undergoing TACE at our center. Patients were further subdivided into groups according to therapy combinations (therapies applied before and after index TACE). Kaplan–Meier survival curves were calculated for the Barcelona Center for Liver Cancer (BCLC) subgroups. Results: After TACE, the median survival was 28.1 months for BCLC 0, 31.5 months for BCLC A, 20.5 months for BCLC B, 10.8 for BCLC C, and 7.5 months for BCLC D. A lesion size larger than 55 mm was negatively associated with survival (HR 2.8, 95% CI 1.15–6.78). Complications occurred after TACE procedures: Clavien–Dindo I + II = 30, Clavien–Dindo > 3 = 2. Conclusions: TACE was performed in a substantial part of our cohort outside of routinely used treatment guidelines. The combination of the survival data and complication rate in these patients suggests it was a safe and beneficial strategy. Furthermore, our data show that in our cohort, the survival benefit associated with TACE was restricted to patients with a lesion size smaller than 55 mm.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Cohort Analysis of Transarterial Chemoembolization for Hepatocellular Cancer at a Tertiary Center in Switzerland

Haak,

Karli,

Takes

et al. 2024

JCM

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“…Comparing the results with some other authors is shown in Table 4 [14][15][16][17] Therefore, there are differences in survival bene ts among studies, so it is necessary to identify prognostic factors that can predict the survival of patients treated with DEB-TACE. In our study, patients with good ECOG performance status scores of 0-1 and ALBI grade I were associated with better survival outcomes.…”

Section: Discussionmentioning

confidence: 99%

Long-term survival outcomes of drug-eluting bead transarterial chemoembolization in patients with hepatocellular carcinoma in Vietnam

Binh,

Thai,

Giang

et al. 2023

Preprint

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Aim To evaluate the efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) and determined prognostic factors affecting patients with HCC. Methods A total of 477 Vietnamese patients diagnosed with HCC underwent DEB-TACE. Patient survival was assessed using the Kaplan–Meier method, and prognostic factors affecting survival were assessed using log-rank tests and Cox proportional hazards regression. Results Among the 477 patients (437 males, mean age 61.1 ± 11.7 years) who underwent DEB-TACE, the median clinical follow-up was 25.3 (1–63) months. Treated response according to the Modified RECIST in patients followed up beyond 6 months included a complete response (CR) in 41 patients (8.7%), partial response (PR) in 352 (74.9%), stable disease (SD) and progressive disease (PD) in 77 (16.1%). The median overall survival (OS) was 53 ± 1.1 months. Factors associated with longer OS included ECOG ≤ 1, Child-Pugh A, BCLC stage A/B, ALBI grade I, and tumor response (CR/PR). In multivariate analysis, Child-Pugh A and objective tumor response (CR/PR) were predictors of longer OS. Conclusion DEB-TACE was an effective treatment for HCC. Child-Pugh A before TACE and tumor response (CR/PR) were positive prognostic factors.

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“…The overall comparative safety and efficacy of cTACE vs DEB-TACE needs further exploration and likely has significant situational considerations which must be applied. Other areas of TACE outcomes that warrant further investigation include more rigorous standardization of cTACE protocols[ 57 ], the efficacy and considerations of TACE in portal vein thrombosis, and TACE for larger (> 5 cm) or multifocal lesions[ 58 ]. Primary outcomes for TACE, as well as the other forms of locoregional therapy discussed here, can be viewed in Table 2 .…”

Section: Tacementioning

confidence: 99%

Hepatocellular carcinoma locoregional therapies: Outcomes and future horizons

Makary¹,

Ramsell²,

Miller³

et al. 2021

WJG

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Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver and has an overall five-year survival rate of less than twenty percent. For patients with unresectable disease, evolving liver-directed locoregional therapies provide efficacious treatment across the spectrum of disease stages and via a variety of catheter-directed and percutaneous techniques. Goals of locoregional therapies in HCC may include curative intent in early-stage disease, bridging or downstaging to surgical resection or transplantation for early or intermediate-stage disease, and local disease control and palliation in advanced-stage disease. This review explores the outcomes of chemoembolization, bland embolization, radioembolization, and percutaneous ablative therapies. Attention is also given to prognostic factors related to each of the respective techniques, as well as future directions of locoregional therapies for HCC.

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Survival and Outcome in Patients Receiving Drug-Eluting Beads Transarterial Chemoembolization for Large Hepatocellular Carcinoma (>5 cm)

Cited by 9 publications

References 19 publications

A Retrospective Cohort Analysis of Transarterial Chemoembolization for Hepatocellular Cancer at a Tertiary Center in Switzerland

A Retrospective Cohort Analysis of Transarterial Chemoembolization for Hepatocellular Cancer at a Tertiary Center in Switzerland

Long-term survival outcomes of drug-eluting bead transarterial chemoembolization in patients with hepatocellular carcinoma in Vietnam

Hepatocellular carcinoma locoregional therapies: Outcomes and future horizons

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