scholarly journals Position 1: Transarterial Chemoembolization Should Be the Primary Locoregional Therapy for Unresectable Hepatocelluar Carcinoma

2020 ◽  
Vol 15 (2) ◽  
pp. 71-73
Author(s):  
Wasseem Skef ◽  
Mitali Agarwal ◽  
Adam E. Mikolajczyk
Keyword(s):  
Transarterial Chemoembolization ◽  
Locoregional Therapy ◽  
Hepatocelluar Carcinoma

scholarly journals Role of multislice computed tomography 3D volumetric analysis in the assessment of the therapeutic response of hepatocellular carcinoma after transarterial chemoembolization

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mohamed Fouad Osman ◽  
Ahmed Shawky Ali Farag ◽  
Haney Ahmed Samy ◽  
Tamer Mahmoud El-Baz ◽  
Shaima Fattouh Elkholy
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Therapeutic Response ◽  
Interventional Procedure ◽  
Liver Volume ◽  
Three Dimensional ◽  
Volumetric Analysis ◽  
Three Dimensions ◽  
Locoregional Therapy ◽  
Significant Difference

Abstract Background Volumetric analysis is a novel radiological technique used in the measurement of target lesions in three dimensions in order to estimate the lesion’s volume. Recently, it has been used for evaluation of the remaining liver volume after partial hepatectomy and also for evaluation of the response of tumours to treatment. It has been proven to be more accurate than the standard one or two-dimensional measurements, and it is especially useful for the evaluation of complex tumours after radiological interventional methods when the use of standard methods is limited. In the current study, our aim was to evaluate the value of the three-dimensional (3D) volumetric method “Response Evaluation Criteria in Solid Tumours (vRECIST)” and to compare it with the non–three-dimensional methods (RECIST) and modified RECIST (mRECIST) in the assessment of the therapeutic response of hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Results A retrospective study was conducted on 50 patients with confirmed radiological or pathological diagnosis of hepatocellular carcinoma (HCC) who underwent TACE as the only interventional procedure and follwed up by triphasic CT 1 and 4 months after treatment. The study revealed a significant difference between mRECIST and vRECIST in the assessment of the therapeutic response of HCC after TACE, a weak agreement was found between both methods in the detection of complete response (CR), partial response (PR), stable disease (SD) or progressive disease (PD). Also, there was no significant agreement between mRECIST and vRECIST regarding the assessment by classifying the patients into responders or nonresponders. Conclusion Volumetric analysis is an effective method for measuring the HCC lesions and evaluating its response to locoregional treatment with a significant difference between vRECIST and mRECIST in the assessment of therapeutic response, which in turn help the interventional radiologist to decide the future treatments and change the therapeutic plans. Based on these results, we recommend vRECIST to be an essential part of the assessment of therapeutic response after locoregional therapy.

scholarly journals Intraarterial contrast-enhanced ultrasound to predict the short-term tumour response of hepatocellular carcinoma to Transarterial chemoembolization with Lipiodol

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiang Bo ◽  
Han Peng ◽  
Zhu LianHua ◽  
Fei Xiang ◽  
Luo YuKun
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Model ◽  
Predictive Value ◽  
Transarterial Chemoembolization ◽  
Characteristic Curve ◽  
Tumour Response ◽  
Locoregional Therapy ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Corona Enhancement

Abstract Background Transarterial chemoembolization (TACE) is an effective locoregional therapy in hepatocellular carcinoma (HCC). However, it is difficult to predict the tumour response (TR) of TACE intraprocedurally. The aim of this study was to predict the TR after TACE (1–3 months) in HCC patients using intraprocedural intraarterial contrast enhanced ultrasound (IA-CEUS). Methods In this case-control study, consecutive patients who received TACE in our hospital from September 2018 to May 2019 were enrolled. IA-CEUS was performed before and after TACE. Postoperative contrast-enhanced liver MRI was performed 1–3 months after TACE as the gold standard. According to the modified Response Evaluation Criteria in Solid Tumours (mRECIST), ultrasonic manifestations were compared between the complete remission (CR) group and non-CR group by univariate and multivariate analyses. A logistic predictive model was established and validated, and its diagnostic efficiency was evaluated. Results Forty-four patients with sixty-one lesions were enrolled in the study. Multivariate analysis identified, the risk factors as a large lesion diameter (OR: 1.84; 95% confidence interval [CI]: 1.009, 3.080; P = 0.020), a larger dimension of non-enhancing area in superior mesenteric artery (SMA)-CEUS than the size in B-mode ultrasound preoperatively (OR: 3.379; 95% CI: 1.346,8.484; P = 0.010), presence of corona enhancement in hepatic artery (HA)-CEUS postoperatively (OR: 6.642; 95% CI: 1.214, 36.331; P = 0.029), and decreased corona enhancement thickness (per centimetre) postoperatively (OR: 0.025; 95% CI: 0.006,0.718; P = 0.025). The area under the receiver operating characteristic curve (AUROC) of the predictive model was 0.904 (95% CI: 0.804, 0.966; P < 0.001). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 81.08, 91.67, 85.25, 93.75, and 75.86%, respectively. Leave-one-out cross-validation (LOOCV) showed that the accuracy was 77.05%. Conclusions Intraprocedural IA-CEUS can be used to predict the TR in HCC patients after TACE.

Locoregional Therapy for Hepatic Neuroendocrine Metastases

2017 ◽  
Vol 01 (03) ◽  
pp. 218-224
Author(s):  
Zachary Bercu ◽  
Jason Mitchell ◽  
Juan Camacho ◽  
Darren Kies ◽  
Eric Friedberg ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Transarterial Chemoembolization ◽  
Transarterial Embolization ◽  
Management Team ◽  
Locoregional Therapy ◽  
Multidisciplinary Management ◽  
Selective Internal Radiotherapy ◽  
Clinical Behavior ◽  
Internal Radiotherapy ◽  
Ablative Techniques

AbstractNeuroendocrine tumors are a heterogeneous group of malignancies with diverse biological and clinical behavior. Locoregional treatments available for the initial and temporal management of neuroendocrine tumors involving the liver include transarterial embolization, transarterial chemoembolization, selective internal radiotherapy, and ablative techniques. These therapies are best employed as part of a multidisciplinary management team focusing on appropriate histopathology, timing, and individuality of each intervention.

Comparison of conventional transarterial chemoembolization (TACE) and chemoembolization with doxorubicin drug eluting beads (DEB) for unresectable hepatocelluar carcinoma (HCC)

2010 ◽  
Vol 101 (6) ◽  
pp. 476-480 ◽  
Author(s):  
Renumathy Dhanasekaran ◽  
David A. Kooby ◽  
Charles A. Staley ◽  
John S. Kauh ◽  
Vinit Khanna ◽  
...  
Keyword(s):  
Transarterial Chemoembolization ◽  
Hepatocelluar Carcinoma ◽  
Drug Eluting Beads ◽  
Drug Eluting

scholarly journals Complex treatment of hepatocellular carcinoma at early (BCLC-A) and intermediate (BCLC-B) stages

2020 ◽  
Vol 25 (2) ◽  
pp. 55-66
Author(s):  
B. N. Kotiv ◽  
I. I. Dzidzava ◽  
S. A. Alent’yev ◽  
A. V. Smorodsky ◽  
K. I. Makhmudov ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Targeted Therapy ◽  
Radiofrequency Ablation ◽  
Liver Resection ◽  
Transarterial Chemoembolization ◽  
Survival Rates ◽  
Locoregional Therapy ◽  
Group 2 ◽  
Group 1

Аim. Evaluation of the effectiveness of hepatocellular carcinoma treatment at early BCLC-A and intermediate BCLC-B stages by the combined use of liver resections and locoregional therapy.Materials and methods. The study included 142 patients with hepatocellular carcinoma. At the BCLC-A stage – 46 observations, at the BCLC-B stage – 96 observations. Chronic hepatitis and cirrhosis of various etiologies were detected in 58 (40.8%) patients. Liver resection of various volumes, transarterial chemoembolization and radiofrequency ablation were used for treatment. With the tumor progression and the ineffectiveness of locoregional therapy, targeted therapy was prescribed.Results. Four groups of patients were identified depending on treatment tactics. In group 1, 28 patients underwent radical liver resections; in group 2, 37 patients underwent preoperative transarterial chemoembolization and liver resection. In group 3, 63 patients underwent therapeutic transarterial chemoembolization and radiofrequency ablation. In group 4, 14 patients underwent transarterial chemoembolization followed by hepatic arterial infusion of chemotherapy and targeted therapy. Overall survival in groups 1 and 2 significantly exceeds survival rates in groups 3 and 4. The median overall survival in groups 1–4 was 39, 37.5, 19.5, and 7.5 months (p1–3 = 0.0001 ; p1–4 = 0.0009, p2–3 = 0.018 , p 2–4 = 0.001). The cumulative one, three and five year survival rates in groups 1 and 2 did not significantly differ (87.8% and 80.0%, 82.5% and 75.0%, 68.2% and 58.0%, 54.5% and 41.0%, respectively, p1–2 = 0.076). However, group 1 consisted exclusively of patients with BCLC-A stages with solitary tumors less than 6.5 cm in diameter, group 2 included large BCLC-A tumors and multiple tumors BCLC-B stages (67.6%).Conclusion. For the treatment of patients with hepatocellular carcinoma BCLC-A and BCLC-B stages, a multimodal approach should be applied, including differential use and a rational combination of regional chemotherapy and resection techniques, taking into account the functional state of the liver.

Transarterial chemoembolization (TACE) does have little impact on hepatic metabolic function in patients with hepatocelluar carcinoma (HCC).

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. e14527-e14527 ◽  
Author(s):  
K. Schuette ◽  
J. Bornschein ◽  
O. Milbradt ◽  
K. Mohnike ◽  
P. Stuebs ◽  
...  
Keyword(s):  
Transarterial Chemoembolization ◽  
Metabolic Function ◽  
Hepatocelluar Carcinoma

Effect of extrahepatic disease on transarterial chemoembolization for metastatic carcinoid.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 283-283
Author(s):  
D. Arrese ◽  
E. Feria-Arias ◽  
H. Khabiri ◽  
G. Guy ◽  
C. R. Schmidt ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Metastatic Disease ◽  
Transarterial Chemoembolization ◽  
Symptom Control ◽  
Hepatic Metastases ◽  
Hepatic Disease ◽  
Locoregional Therapy ◽  
Extrahepatic Disease ◽  
Radiographic Response ◽  
The Impact

283 Background: Transarterial chemoembolization (TACE) is the locoregional therapy of choice for the management of patients with inoperable carcinoid liver metastases. Often, metastatic disease is not limited to the liver. The impact of extra-hepatic metastases on response and outcomes following TACE has not been described. Objective: We hypothesized that patients who have extra-hepatic disease would have similar tumor response and symptom control following TACE. Methods: We reviewed 198 patients that underwent TACE for inoperable carcinoid liver metastases. Two groups were identified, those with (N= 129) and without (N= 69) evidence of extra-hepatic disease at the time of TACE. Demographics, clinicopathologic characteristics, response to TACE, complications, and survival were compared. Results: The two groups were similar in demographics and histopathologic characteristics. Complications following TACE were similar. There was no difference between the groups with and without evidence of extrahepatic disease in symptomatic (76% vs 71%), biochemical (78% vs 90%) or radiographic response (35.0% vs 46%) to TACE. The group without extra-hepatic disease had a median survival of 88 vs 35 months with five-year survival of 65% vs 30% compared to patients with extra-hepatic disease at the time of TACE. Conclusions: Patients with extrahepatic metastatic disease from carcinoid tumor experienced shorter overall survival following TACE compared to those without extrahepatic disease. However, patients with extra- hepatic disease had similar symptomatic, biochemical and radiographic response to TACE compared to those with disease confined to the liver. Although the long-term prognosis for patients with extrahepatic disease is worse than those with liver-only metastasis, meaningful response to TACE is possible and should be considered. No significant financial relationships to disclose.

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