The Effectiveness of Locoregional Therapies versus Supportive Care in Maintaining Survival within the Milan Criteria in Patients with Hepatocellular Carcinoma

Dhanasekaran, Renumathy; Khanna, Vinit; Kooby, David A.; Spivey, James R.; Parekh, Samir; Knechtle, Stuart J.; Carew, John D.; Kauh, John S.

doi:10.1016/j.jvir.2010.04.018

Cited by 17 publications

(5 citation statements)

References 17 publications

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“…This finding was supported by our previous study that RFA provided better survival than TACE in patients within the Milan criteria, especially in patients with small tumour burden . Moreover, consistent with most published studies, patients receiving surgical resection, local ablation and TACE had a better survival when compared with patients receiving other treatments . Taken together, our data indicate that treatment strategy is closely linked with the survival and should be taken into consideration when a prognostic model is to be constructed.…”

Section: Discussionsupporting

confidence: 89%

A prognostic model for patients with hepatocellular carcinoma within the Milan criteria undergoing non‐transplant therapies, based on 1106 patients

Lee

Hsu

Hsia

et al. 2012

Aliment Pharmacol Ther

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Section: Discussionsupporting

confidence: 89%

A prognostic model for patients with hepatocellular carcinoma within the Milan criteria undergoing non‐transplant therapies, based on 1106 patients

Lee

Hsu

Hsia

et al. 2012

Aliment Pharmacol Ther

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“…19 In people with nonresectable HC, TACE shows improved median survival time (MST) vs conservative management. [20][21][22][23][24] Compared to conventional TACE, DEB-TACE might show comparable or improved efficacy and fewer adverse effects, [25][26][27][28][29][30] leading to the current investigation of DEB-TACE in dogs.…”

Section: Introductionmentioning

confidence: 99%

Drug‐eluting bead chemoembolization for the treatment of nonresectable hepatic carcinoma in dogs: A prospective clinical trial

Rogatko

Weisse

Schwarz

et al. 2021

Veterinary Internal Medicne

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Background: Effective treatment options for nonresectable hepatic carcinoma (HC) in dogs are limited.Hypothesis/Objective: Objectives were to report outcomes, complications, and tumor responses via computed tomography (CT) assessment after drug-eluting bead transarterial chemoembolization (DEB-TACE) for nonresectable HC in dogs. The authors hypothesized that major complications would be uncommon and short-term CT assessment would demonstrate stable disease or partial response.Animals: Client-owned dogs (n = 16) with nonresectable HC.Methods: Prospective, single-arm clinical trial. Drug-eluting bead transarterial chemoembolization was performed to varying levels of blood flow stasis. Computed tomography imaging was compared before and approximately 12 weeks after initial treatment.Results: Drug-eluting bead transarterial chemoembolization was successfully administered in all attempts. Based on percent change in elliptical tumor volume response (mL), stable disease (8/13; 62%) was the most common outcome followed by partial response (3/13; 23%) and progressive disease (2/13; 15%) with a median of 74 days (range, 39-125) after initial treatment. Median tumor volume (mL) after DEB-TACE decreased in volume by 13% (range, 56% decrease to 77% increase). Mild complications consistent with postembolization syndrome occurred after 7/27 (26%) treatments. Major complications occurred after 3/27 (11%) treatments: hepatic abscess/

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“…However, there has been a wide discrepancy between the number of available donor organs and the waiting list of transplantation candidates, which has consequently led to long waiting periods for transplantation. In this context, a previous study by Dhanasekaran et al ( 17 ) demonstrated a role for chemoembolization as a "bridging therapy"to control and maintain tumor burden within the Milan criteria during that waiting period in Child-Pugh class A and B candidates. In addition, our study also showed that the patients whose tumor burden was within the Milan criteria had significantly lower and relatively acceptable incidence of major chemoembolization-related complications and a higher tumor response rate to chemoembolization compared with those with a large tumor burden.…”

Section: Discussionmentioning

confidence: 98%

The Safety and Clinical Outcomes of Chemoembolization in Child-Pugh Class C Patients with Hepatocellular Carcinomas

et al. 2015

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ObjectiveTo evaluate the safety and clinical outcomes of chemoembolization in Child-Pugh class C patients with hepatocellular carcinomas (HCC).Materials and MethodsThe study comprised 55 patients with HCC who were classified as Child-Pugh class C and who underwent initial chemoembolization between January 2003 and December 2012. Selective chemoembolization was performed in all technically feasible cases to minimize procedure-related complications. All adverse events within 30 days were recorded using the Common Terminology Criteria for Adverse Events (CTCAE). The tumor response to chemoembolization was evaluated using the modified Response Evaluation Criteria In Solid Tumors.ResultsThirty (54.5%) patients were within the Milan criteria, and 25 (45.5%) were beyond. The mortality of study subjects at 30 days was 5.5%. Major complications were observed in five (9.1%) patients who were all beyond the Milan criteria: two hepatic failures, one hepatic encephalopathy, and two CTCAE grade 3 increases in aspartate aminotransferase/alanine aminotransferase abnormality. The mean length of hospitalization was 6.3 ± 8.3 days (standard deviation), and 18 (32.7%) patients were discharged on the next day after chemoembolization. The tumor responses of the patients who met the Milan criteria were significantly higher (p = 0.014) than those of the patients who did not. The overall median survival was 7.1 months (95% confidence interval: 4.4-9.8 months).ConclusionEven in patients with Child-Pugh class C, chemoembolization can be performed safely with a selective technique in selected cases with a small tumor burden.

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The Effectiveness of Locoregional Therapies versus Supportive Care in Maintaining Survival within the Milan Criteria in Patients with Hepatocellular Carcinoma

Cited by 17 publications

References 17 publications

A prognostic model for patients with hepatocellular carcinoma within the Milan criteria undergoing non‐transplant therapies, based on 1106 patients

A prognostic model for patients with hepatocellular carcinoma within the Milan criteria undergoing non‐transplant therapies, based on 1106 patients

Drug‐eluting bead chemoembolization for the treatment of nonresectable hepatic carcinoma in dogs: A prospective clinical trial

The Safety and Clinical Outcomes of Chemoembolization in Child-Pugh Class C Patients with Hepatocellular Carcinomas

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