No abstract available.
Tomography, X-Ray Computed ; Liver Neoplasms/*radiography/*therapy ; Humans ; *Chemoembolization, Therapeutic/methods ; Carcinoma, Hepatocellular/radiography/*therapy

Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; methods ; Hepatic Artery ; Humans ; Liver Neoplasms ; therapy ; Magnetic Resonance Imaging

Objective: To explore the predictive factors of concurrent bile duct injury following transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: A retrospective study was conducted on 483 HCC patients in relation to TACE postoperative complications. A total of 21 cases of bile duct injury were observed following the TACE procedure. Laboratory data, imaging data, and clinically relevant medical histories were recorded before and after one week following the TACE procedure and follow-up. The χ (2) test, or Fisher's exact probability method, was used for categorical variables. The mean of the two samples was compared using a paired t-test or Wilcoxon rank sum test. The comparison of multiple mean values was conducted using an analysis of variance. Results: Twenty-one cases with bile duct injury had intrahepatic bile duct dilatation, bile tumors, hilar biliary duct stenoses, and other manifestations. 14.3% (3/21) of patients showed linear high-density shadows along the bile duct on a plain CT scan, while 76.2% (16/21) of patients had ALP > 200 U/L one week following TACE procedure, and bile duct injury occurred in later follow-up. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT) were significantly increased in all patients following TACE procedure (t = -2.721, P = 0.014; t = -2.674, P = 0.015; t = -3.079, P = 0.006; t = -3.377, P = 0.003, respectively). Conclusion: The deposition of iodized oil around the bile duct on plain CT scan presentation or the continuous increase of ALP (> 200 U/L) one week following TACE procedure has a certain predictive value for the later bile duct injury.
Humans ; Liver Neoplasms/therapy* ; Carcinoma, Hepatocellular/therapy* ; Retrospective Studies ; Chemoembolization, Therapeutic/methods* ; Bile Ducts

Cerebral lipiodol embolism (CLE) is an extremely rare complication of transcatheter arterial chemoembolization for hepatocellular carcinoma. To our knowledge, only 11 cases have been previously reported. We recently encountered two cases of CLE in our clinical work. Reviewing the 11 cases in the literature and the two cases in our report indicates that large dose lipiodol infusion and absence of particulate embolization should be avoided. The presence of a right-to-left shunt and inferior phrenic artery injection seems to increase the risk of CLE. More caution should be taken in these situations.
Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; methods ; Ethiodized Oil ; therapeutic use ; Humans ; Liver Neoplasms ; therapy ; Male ; Middle Aged

The incidence and mortality of liver cancer are high, which seriously threatens human life and health. Common treatment methods for liver cancer include surgical treatment, transcatheter arterial chemoembolization, targeted therapy, radiotherapy and chemotherapy, etc. These methods have various problems when used alone. This paper reviews the research on the treatment of liver cancer with compound injection of traditional Chinese medicine and its mechanism in recent years, in order to provide some reference for clinical treatment and improvement of prognosis of liver cancer.
Humans ; Liver Neoplasms/therapy* ; Chemoembolization, Therapeutic/methods* ; Carcinoma, Hepatocellular/therapy* ; Medicine, Chinese Traditional ; Prognosis ; Drugs, Chinese Herbal/therapeutic use*

Adult ; Aged ; Chemoembolization, Therapeutic ; methods ; Female ; Humans ; Liver Neoplasms ; pathology ; therapy ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Treatment Outcome

Despite remarkable advancement in the surveillance and treatment of hepatocellular carcinoma (HCC) and the availability of novel curative options, a great proportion of HCC patients are still not eligible for curative treatment due to an advanced tumor stage or poor hepatic functional reserve. Therefore, there is a continuing need for effective palliative treatments. Although practiced widely, it has only recently been demonstrated that the use of transarterial chemoembolization (TACE) provides a survival benefit based on randomized controlled studies. Hence, TACE has become standard treatment in selected patients. TACE combines the effect of targeted chemotherapy with the effect of ischemic necrosis induced by arterial embolization. Most of the TACE procedures have been based on iodized oil utilizing the microembolic and drug-carrying characteristic of iodized oil. Recently, there have been efforts to improve the delivery of chemotherapeutic agents to a tumor. In this review, the basic principles, technical issues and complications of TACE are reviewed and recent advancement in TACE technique and clinical applicability are briefed.
Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/*therapy ; Chemoembolization, Therapeutic/*methods ; Gelatin Sponge, Absorbable/therapeutic use ; Humans ; Infusions, Intra-Arterial ; Iodized Oil/therapeutic use ; Liver Neoplasms/*therapy

BACKGROUNDEmbolization of collateral arteries is important for transcatheter hepatic arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). We evaluated the efficacy and safety of TACE, and the prevention and management of complications among patients in whom the internal thoracic artery (ITA) was involved.

METHODSA total of 3614 cases of HCC were treated with 12 645 TACEs and 211 of these cases were given ITA angiography, including 156 cases of which the ITA was involved. We performed 562 TACEs in the 156 cases. We analyzed imaging examinations, types of embolization, and the incidence, prevention, and treatment of complications.

RESULTSThe ITA was successfully embolized in 156 cases. Angiography of the ITA showed that the major trunks were thickened with an increased number of branching vessels, contributing to intrahepatic and extrahepatic tumor blood supply. Different embolization methods were selected according to the blood supply, to effectively embolize the tumor and mitigate or avoid serious complications. TACE with ITA embolization extended the mean interval time between two treatments from 2.54 months (1 - 17 months) to 4.23 months (1 - 30 months) compared with that without ITA embolization. The ITA supplied the HCC in the following instances: HCC was located in the ventral hepatic area and abutted the diaphragm (P = 0.0064) and repeated TACE (P = 0.0003). The survival rate of TACE with ITA embolization for HCC was better than TACE without ITA embolization (P < 0.00001).

CONCLUSIONSIn cases with massive HCC or nodular HCC, the ITA may be involved in supplying blood to the tumor. This occurs when the tumor is positioned in the ventral hepatic area and abuts the diaphragm (S2, S4, and S8), and especially if cases have a previous history of TACE. In this case series, embolization was effective, extended the mean interval time of interventional therapy, and prolonged survival time.

Adult ; Aged ; Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; methods ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Mammary Arteries ; Middle Aged ; Treatment Outcome

OBJECTIVETo evaluate the therapeutic effect of combined CT-guided percutaneous radio-frequency ablation (RFA) plus percutaneous ethanol injection (PEI) on nonresectable priminary hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE).

METHODSOne hundred fifty patients diagnosed as HCC either by pathology or by AFP combined with typical CT and angiographic image findings were studied, 99 men and 51 women, with an average of 51 years. Each patient had at least 3 lesions, ranging from 3.1 to 7.9 cm in diameter, average 5.0 cm. All patients were randomly divided into group A (control group) and group B (combination group) according to their check-in date (odd or even). In group A, 74 patients were treated with RFA alone two weeks after TACE. In group B, 76 patients were treated with RFA plus PEI two weeks after TACE.

RESULTSThe complete necrosis rate was 75.8% in group A and 89.5% in group B (P < 0.05).

CONCLUSIONThe clinical therapeutic effect of radiofrequency ablation (RFA) combined with percutaneous ethanol injection (PEI) is better than that of RFA alone after TACE in HCC.

Carcinoma, Hepatocellular ; therapy ; Catheter Ablation ; methods ; Chemoembolization, Therapeutic ; Ethanol ; administration & dosage ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Treatment Outcome

Transcatheter arterial chemoembolization (TACE) is the most commonly used method for non-surgical treatment of liver cancer, and it is usually used as an adjuvant therapy in patients who have not developed intrahepatic metastases after surgical resection. Postoperative adjuvant TACE therapy may provide a prognostic benefit in liver cancer patients with high recurrence risk. This article reviews the research progress of adjuvant TACE therapy for liver cancer after radical resection.
Carcinoma, Hepatocellular/pathology* ; Chemoembolization, Therapeutic/methods* ; Hepatectomy ; Humans ; Liver Neoplasms/pathology* ; Neoplasm Recurrence, Local/pathology* ; Retrospective Studies