Transarterial embolization with hepatectomy for ruptured hepatocellular carcinoma: a meta-analysis

Zhang, Fengqin; Lin, Li; Huang, Ping-Chao; Fu, Yu‐Fei; Xu, Qingsong

doi:10.1080/13645706.2021.1986724

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…As HCC rupture is always accompanied by coagulopathy or poor liver function, only a limited number of patients can tolerate surgical hepatic resection (18,19). Compared with emergency hepatectomy for ruptured HCC, transarterial embolization (TAE) with staged hepatectomy can effectively decrease intraoperative blood loss and 30-day mortality (20).…”

Section: Discussionmentioning

confidence: 99%

Development of a prognostic score for recommended transarterial chemoembolization candidates with spontaneous rupture of hepatocellular carcinoma

Zou¹,

Jia²,

Chen³

et al. 2022

J Gastrointest Oncol

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Background: Although transarterial chemoembolization (TACE) has been widely used for treating the spontaneous rupture of hepatocellular carcinoma (HCC), no existing model exists for predicting survival.The aim of this study was thus to develop and validate a nomogram for estimating the prognosis in patients with ruptured HCC upon undergoing TACE treatment. Methods: This study included 55 patients with spontaneously ruptured HCC who underwent TACE treatment between January 2015 and April 2019. The diagnosis of spontaneous HCC rupture was based on the disruption of the peritumoral liver capsule with surrounding fluid in the perihepatic region. The prognostic nomogram was constructed using the independent predictors assessed by the multivariate Cox proportional hazards model. Results:The median overall survival (OS) was 6.4 months, with 6-month and 1-year survival rates of 52.7% and 41.8%, respectively. In the univariate analysis, the size of the largest tumor, total bilirubin (TBIL) levels, and aspartate aminotransferase (AST) levels were associated with the OS of patients. Multivariate analysis suggested that TBIL levels (HR =0.358, P=0.036) and diameter of the largest tumor (HR =1.012, P=0.044) were independent prognostic factors for predicting the OS. Based on these variables, we developed and validated a nomogram for the risk stratification of HCC rupture after TACE treatment for individual patients. According to the nomogram risk assessment, we were able to evaluate the approximate 1-and 2-year survival rates based on patients' tumor diameter and TBIL level after TACE treatment of ruptured HCC.The concordance index for the OS prediction was 0.748 (95% CI: 0.691-0.805). This newly developed nomogram represents an intuitive tool for predicting the OS of patients with ruptured HCC.Conclusions: This study indicated that TBIL levels and diameter of the largest tumor were independent prognostic factors for predicting the OS of ruptured HCC. This study may help maximize favorable TACE treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

Development of a prognostic score for recommended transarterial chemoembolization candidates with spontaneous rupture of hepatocellular carcinoma

Zou¹,

Jia²,

Chen³

et al. 2022

J Gastrointest Oncol

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“…Moreover, whether HCC is ruptured, staged hepatectomy is recommended ( 12 , 20 , 82 ). It should be noted that a meta-analysis ( 83 ) reported that long-term staged hepatectomy might not be more beneficial than emergency hepatectomy. However, in this meta-analysis, we found that the authors did not mention how they acquire survival data to estimate hazard ratio from included studies and their results contradict the studies that they included; thus, their conclusion should be interpreted with caution.…”

Section: Transarterial Embolization/transarterial Chemoembolization F...mentioning

confidence: 99%

Ruptured Hepatocellular Carcinoma: What Do Interventional Radiologists Need to Know?

Yan

Deng

et al. 2022

Front. Oncol.

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Rupture of HCC (rHCC) is a life-threatening complication of hepatocellular carcinoma (HCC), and rHCC may lead to a high rate of peritoneal dissemination and affect survival negatively. Treatment for rHCC mainly includes emergency surgery, interventional therapies, and palliative treatment. However, the management of rHCC should be carefully evaluated. For patients with severe bleeding, who are not tolerant to open surgery, quick hemostatic methods such as rupture tissue ablation and TAE/TACE can be performed. We described clinical presentation, prognosis, complication, interventional management, and current evidence of rHCC from the perspective of interventional radiologists. Overall, our review summarized that interventional therapies are necessary for most patients with rHCC to achieve hemostasis, even in some patients with Child–Pugh C. Moreover, TAE/TACE followed by staged hepatectomy is a beneficial treatment for rHCC according to current clinical evidence. TAE/TACE is the first choice for most patients with rHCC, and appropriate interventional treatment may provide staged surgery opportunities for those who are not tolerant to emergency surgery to reach an ideal prognosis.

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Poly(terephthalic acid diallyl ester) embedded by tantalum microspheres (PTADE@Ta) for precise and long-term X-ray imaging in the embolization

Xiao,

Ai,

Chen

et al. 2024

Polym. Bull.

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Transarterial embolization with hepatectomy for ruptured hepatocellular carcinoma: a meta-analysis

Cited by 3 publications

References 24 publications

Development of a prognostic score for recommended transarterial chemoembolization candidates with spontaneous rupture of hepatocellular carcinoma

Development of a prognostic score for recommended transarterial chemoembolization candidates with spontaneous rupture of hepatocellular carcinoma

Ruptured Hepatocellular Carcinoma: What Do Interventional Radiologists Need to Know?

Poly(terephthalic acid diallyl ester) embedded by tantalum microspheres (PTADE@Ta) for precise and long-term X-ray imaging in the embolization

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