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

Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; Humans ; Liver Neoplasms ; therapy

Chemoembolization, Therapeutic ; Humans ; Liver Neoplasms ; metabolism ; therapy ; Tetraspanin 24 ; metabolism

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

*Chemoembolization, Therapeutic ; Liver Neoplasms, Experimental/*therapy ; Microspheres ; Polyglactin 910/*therapeutic use ; Rats, Inbred ACI

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

OBJECTIVETo evaluate the therapeutic effects and adverse effects of transarterial oily chemoembolization combined with interstitial laser thermotherapy (TOCE+ILT) in the treatment of hepatocellular carcinoma.

METHODSTotally 120 patients with hepatocellular carcinoma were randomized into two groups and received interventions with TOCE+ILT or TOCE combined with percutaneous ethanol injection (TOCE+PEI). The treatment was repeated when necessary until the tumor was completely ablated, after which the therapeutic effects were evaluated and the patients were the followed up for observing long-term clinical outcome.

RESULTSOf the 120 patients enrolled in this observation, 105 were followed up for two years (54 in TOCE+ILT group and 51 in TOCE+PEI group). The complete tumor necrosis rate of TOCE+ILT group was significantly higher than that of the TOCE+PEI group (84.8% vs 73.9%,Chi(2)=4.405, P=0.036), and TOCE+ILT was associated with a significantly higher negative conversion rate of AFP positivity (77.8% vs 56.1%, Chi(2)=4.592, P=0.032). The 1-year survival rate were similar between two groups, but the 2-year survival rate was significantly higher in patients with TOCE+ILT (79.6% vs 60.8%, Chi(2)=4.477, P=0.034). The hepatic function was comparable between the two groups before treatment, and 1 week after treatment, the ALT level in patients undergoing TOCE+ILT was significantly lower than that in patients with TOCE+PEI (95.90-/+56.06 U/L vs 116.31-/+45.27 U/L, t=2.04, P=0.043). Post-embolization syndrome was observed in the patients in two groups, but no severe adverse events were found.

CONCLUSIONTOCE+ILT has good therapeutic effects and mild side effects in the treatment of hepatocellular carcinoma.

Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; Humans ; Hyperthermia, Induced ; Lasers ; Liver Neoplasms ; therapy ; Survival Rate ; Treatment Outcome

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

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

Adolescent ; Chemoembolization, Therapeutic ; Child ; Child, Preschool ; Female ; Hepatectomy ; Hepatoblastoma ; therapy ; Humans ; Infant ; Liver Neoplasms ; therapy ; Male