Chemoembolization by using ethanol-soaked gelatin sponge combined with chemotherapeutic drugs and/or iodized oil for HCC complicated by moderate-to-severe hepatic arterio-portal shunts: analysis of curative effect
10.3969/j.issn.1008-794X.2017.09.006
- VernacularTitle:无水乙醇明胶海绵混合物栓塞治疗肝癌合并中重度肝动脉门静脉分流的疗效分析
- Author:
Chun ZHOU
1
;
Weizhong ZHOU
;
Sheng LIU
;
Chungao ZHOU
;
Bin WANG
;
Shaoxian WANG
;
Haibin SHI
Author Information
1. 210029,南京医科大学第一附属医院介入放射科
- Keywords:
ethanol-soaked gelatin sponge mixture;
embolization,therapeutic;
hepatocellular carcinoma;
hepatic arterio-portal shunt;
prognostic factor
- From:
Journal of Interventional Radiology
2017;26(9):793-798
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of peripheral chemoembolization by using ethanol-soaked gelatin sponge (ESG) combined with chemotherapeutic drugs and/or iodized oil in treating patients with hepatocellular carcinoma (HCC) complicated by moderate-to-severe hepatic arterio-portal shunts (APS).Methods The clinical data of 106 HCC patients associated with moderate-to-severe APS,who were treated with ESG chemoembolization during the period from June 2008 to December 2015,were retrospectively analyzed.The postoperative improvement of APS,the procedure-related complications,the tumor response,the survival time,the prognostic factors,etc.were statistically analyzed.Results In the 106 HCC patients associated with moderate-to-severe APS,the median survival time was 278 days,and the 6-,12-and 18-month cumulative survival rates were 70.8%,36.1% and 16%,respectively.Univariate analysis showed that sex,total bilirubin level,maximal tumor diameter,history of previous treatment,tumor response and postoperative improvement of APS were closely correlated with the patient's prognosis.Multivariate regression analysis indicated that tumor response and postoperative improvement of APS were the independent protection factors,while the female sex and the maximal tumor size ≥5 cm were the independent risk factors.Conclusion For the treatment of HCC complicated by moderate-to-severe hepatic APS,transarterial chemoembolization by using ESG combined with chemotherapeutic drugs and/or iodized oil is safe and effective.The presence of tumor response to treatment and the postoperative improvement of APS indicate a better prognosis.The female sex and the maximal tumor size ≥5 cm are the independent prognostic risk factors.