2.Predictive Factors for Complete Response and Recurrence after Transarterial Chemoembolization in Hepatocellular Carcinoma.
Shin Ok JEONG ; Eui Bae KIM ; Soung Won JEONG ; Jae Young JANG ; Sae Hwan LEE ; Sang Gyune KIM ; Sang Woo CHA ; Young Seok KIM ; Young Deok CHO ; Hong Soo KIM ; Boo Sung KIM ; Yong Jae KIM ; Dong Erk GOO ; Su Yeon PARK
Gut and Liver 2017;11(3):409-416
BACKGROUND/AIMS: To investigate the predictive factors for complete response (CR) and recurrence after CR in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). METHODS: Among 691 newly diagnosed HCC patients, 287 were treated with TACE as a first therapy. We analyzed the predictive factors for CR, recurrence after CR, and overall survival (OS). RESULTS: Eighty-one patients (28.2%) achieved CR after TACE, and recurrence after CR was detected in 35 patients (43.2%). In multivariate analyses, tumor size (≤5 cm) and single nodularity were predictive factors for CR, with hazard ratios (HRs) of 0.35 (p=0.002) and 0.41 (p<0.001), respectively. Elevated serum α-fetoprotein (AFP) (>20 ng/mL) level and multinodularity exhibited significant relationships with recurrence after CR, with HRs of 2.220 (p=0.026) and 3.887 (p<0.001), respectively. Tumor size (>5 cm), multinodularity, elevated serum AFP (>20 ng/mL) level, Child-Turcotte-Pugh score (B and C), and portal vein thrombosis were significant factors for OS. CONCLUSIONS: In patients treated with TACE as a first therapy, tumor size (≤5 cm) and single nodularity were predictive factors for CR, and multinodularity and elevated serum AFP (>20 ng/mL) levels were predictive factors for recurrence after CR. These factors were also significant for OS.
Carcinoma, Hepatocellular*
;
Chemoembolization, Therapeutic
;
Humans
;
Multivariate Analysis
;
Recurrence*
;
Venous Thrombosis
4.Intraductal migration of necrotic hepatocellular carcinoma: A possible cause of obstructive cholangitis after chemoembolization
Gastrointestinal Intervention 2018;7(1):29-33
Acute obstructive cholangitis due to the migration of necrotized tumor fragment(s) has been rarely reported after transarterial chemoembolization (TACE). We report an unusual case of it, which was demonstrated by computed tomography (CT) and endoscopic retrograde cholangiography. We suggest that in the setting of acute biliary obstruction after TACE with a CT-demonstrated new intraductal soft tissue lesion with or without a radiopaque portion, along with no or less visualization of a previous tumor located inside or near the duct, the possibility of intraductal migration of a necrotic tumor fragment should be considered. Both clinicians and radiologists should become familiar with this condition because it may be ignored or misinterpreted as biliary calculi.
Carcinoma, Hepatocellular
;
Chemoembolization, Therapeutic
;
Cholangiography
;
Cholangitis
;
Cholestasis
;
Gallstones
5.Experimental study on the effectiveness of transarterial chemoembolization with poly-lactide-Co-glycoside microspheres
Jun, QIAN ; Trubenbach J ; Grapler F ; Pereira P L ; Wiemann G ; Thomas E ; Huppert P E ; Claussen C D
Journal of Huazhong University of Science and Technology (Medical Sciences) 2002;22(4):346-9
7.A Case of Cryptogenic Organizing Pneumonia after Transarterial Chemoembolization for the Treatment of Hepatocellular Carcinoma.
Ah Ran KIM ; Kwang Ha YOO ; Kye Young LEE ; Sun Jong KIM ; Hee Joung KIM ; Jun Hyun KIM ; Yong A RHYU
Tuberculosis and Respiratory Diseases 2015;78(4):469-472
Cryptogenic organizing pneumonia (COP) is an inflammatory lung disease involving the distal bronchioles, respiratory bronchioles, bronchiolar ducts, and alveolae. The etiology is usually unknown; however, there are several known causes and associated systemic diseases. Corticosteroid therapy is the best treatment option and the prognosis of COP is good, with recovery in up to 80% of patients. We described a patient with in-operable hepatocellular carcinoma (HCC) undergoing chemoembolization with doxorubicin in a drug-eluting bead (DEB). COP developed in the patient after chemoembolization but resolved spontaneously in several months.
Bronchioles
;
Carcinoma, Hepatocellular*
;
Chemoembolization, Therapeutic
;
Cryptogenic Organizing Pneumonia*
;
Doxorubicin
;
Humans
;
Lung Diseases
;
Prognosis
9.Long term survival analysis of primary hepatocarcinoma patients received transcatheter arterial chemoembolization plus chemotherapy after radical resection.
Guang-Ping QIU ; Jie LIU ; Hua FAN
Journal of Zhejiang University. Medical sciences 2014;43(6):683-687
OBJECTIVETo evaluate the survival of hepatocellular carcinoma (HCC) patients received prophylactic use of transcatheter arterial chemoembolization (TACE) after radical resection.
METHODSOne hundred and forty-three cases of HCC from Ningbo No.2 Hospital were divided into intervention prevention group, chemotherapy prevention group and comprehensive prevention group according to different methods of HCC prevention. All patients were followed-up for more than 5 years after TACE, chemotherapy (FOLPOX4) or TACE+ FOLPOX4. Cox regression model of multiple factors analysis was used for analyzing impact factors on HCC prognosis. Survival rate was compared with Kaplan-meier method.
RESULTSAlpha-fetoprotein (AFP) was negatively correlated with the survival time of patients, as an independent risk factor with the regression coefficient of 0.01 and the relative risk of 1.00. Prevention of postoperative increased survival time of patients with HCC, which was a protective factor. The regression coefficient for comprehensive prevention was -2.37 and the relative risk was 0.07, the weight of comprehensive prevention on lifetime was higher than that of other two prevention methods, followed by TACE prevention group. One-year, 2-year, 3-year cumulative survival rates in comprehensive prevention group were 78.35%, 69.16%, 24.43%, that in TACE prevention group were 76.87%, 62.48%, 24.72%, and that in chemotherapy prevention group were 62.23%, 43.22%, 19.54%, respectively.
CONCLUSIONAFP was negative correlation with the survival time of postoperative HCC patients, monitored which of postoperative HCC patients can provide a reference for effect and prognosis of surgery. Application of TACE in HCC patients with postoperative effective in reducing mortality, which prolong the survival time of HCC patients might be extended further by combined chemotherapy based on its own advantages and disadvantages.
Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; Humans ; Liver Neoplasms ; therapy ; Prognosis ; Risk Factors ; Survival Analysis
10.Trancatheter arterial chemoembolization in the treatment of hepatoblastoma.
Long LI ; Yong CHEN ; Yan-hao LI ; Qing-le ZENG ; Xiao-feng HE
Chinese Journal of Hepatology 2004;12(3):171-172
Adolescent
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Chemoembolization, Therapeutic
;
Child
;
Child, Preschool
;
Female
;
Hepatectomy
;
Hepatoblastoma
;
therapy
;
Humans
;
Infant
;
Liver Neoplasms
;
therapy
;
Male