scholarly journals Retrospective European Multicentric Evaluation of Selective Transarterial Chemoembolisation with and without Balloon-Occlusion in Patients with Hepatocellular Carcinoma: A Propensity Score Matched Analysis

2021 ◽  
Author(s):  
Rita Golfieri ◽  
Mario Bezzi ◽  
Gontran Verset ◽  
Fabio Fucilli ◽  
Cristina Mosconi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Tumour Response ◽  
Complete Response ◽  
Balloon Occlusion ◽  
Control Group ◽  
Level Of Evidence ◽  
Multicentric Study ◽  
Transarterial Chemoembolisation ◽  
Retreatment Rate

Abstract Purpose The aim of this retrospective multicentric study was to compare the tumour response rates of Balloon-occluded Transarterial Chemoembolisation (B-TACE) to non-B-TACE using propensity score matching (PSM) in patients with hepatocellular carcinoma and to investigate the clinical benefit, such as lower rates of TACE re-intervention achieved using B-TACE. Material and Methods The B-TACE procedures (n = 96 patients) were compared with a control group of non-B-TACE treatments (n = 434 pts), performed with conventional (cTACE) or drug-eluting microspheres TACE (DEM-TACE). Data were collected from six European centres from 2015 to 2019. Objective responses (OR) and complete response (CR) rates after the first session and the number of TACE re-interventions were evaluated using PSM (91 patients per arm). Results The best target OR after PSM were similar for both B-TACE and non-B-TACE (90.1% and 86.8%, p = 0.644); however, CR at 1–6 months was significantly higher for B-TACE (59.3% vs. 41.8%, p = 0.026). Patients treated with B-TACE had a significantly lower retreatment rate during the first 6 months (9.9%% vs. 22.0%, p = 0.041). Post-embolisation syndrome (PES) rates were 8.8% in non-B-TACE and 41.8% in B-TACE (p < 0.001), with no significant differences between groups regarding major adverse events. Conclusion B-TACE is safe and effective, achieving higher CR rates than non-B-TACE. Patients undergoing B-TACE had a significantly lower retreatment rate within the first 6 months but higher PES rates. Level of Evidence III Level 3, retrospective study.

scholarly journals Aspirin Decreases Hepatocellular Carcinoma Risk in Hepatitis C Virus Carriers: A Nationwide Cohort Study

2019 ◽  
Author(s):  
Yen-Hsiang Liao ◽  
Wen-Lin Hsu ◽  
Tzu-Hwei Wang ◽  
Chen-Ta Wu ◽  
Sheng-Yao Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Incidence Rate ◽  
Occurrence Rate ◽  
Control Group ◽  
Cancer Occurrence

Abstract Background Aspirin lowered some cancer occurrence rate, through the inhibition of the cyclooxygenase enzyme. The association of aspirin-use and hepatocellular carcinoma (HCC) occurrence rate in hepatitis B virus (HBV) carriers is well known. However, the association in hepatitis C virus (HCV) carriers is not known. Our purpose is comparing the HCC occurrence rate in HCV carriers with or without Aspirin treatment. Methods In this retrospective cohort study, the participants were ones newly-diagnosed with HCV from 2000 to 2012 in Taiwan. These HCV carriers with aspirin treatment were defined as the control group, whereas those without aspirin were defined as a compared cohort. We used a 1:1 propensity score matching by age, sex, comorbidities, drugs, diagnosis year and index year with covariate assessment. Results Our study sample consisted of 2980 aspirin-treated HCV carriers and 7771 non-aspirin-treated HCV carriers. After propensity score matching, each cohort consisted of 1911 HCV carriers. The adjusted hazard ratio (aHR) of HCC incidence in aspirin users (aHR=0.56, 95% CI=0.43-0.72, p < 0.001 ) was significantly lower than that in non-aspirin users. The Kaplan-Meier curves show that among the HCV carriers, aspirin users had a lower cumulative incidence rate of HCC in the first 10-year aspirin treatment course ( p < 0.0001 ). Conclusions The HCC incidence rate was lower in the aspirin users than non- aspirin users among HCV carriers, supporting the aspirin effect may be acting through inhibition of the cyclooxygenase enzyme pathway. Moreover, the patients got HCC protection by aspirin within 1-year treatment course and had best HCC prevention during 1- to 2-year aspirin treatment course. We encourage aspirin treatment to prevent HCC in HCV carriers.

scholarly journals Trans-arterial chemoembolization (TACE) in treatment of non-resectable hepatocellular carcinoma: comparative study between conventional TACE and drug eluting bead TACE

2020 ◽  
Vol 11 (3) ◽  
pp. 4733-4741
Author(s):  
Amgad M.Elsheikh ◽  
Mohamed I.Teama ◽  
Afify F. Afify ◽  
Mohamed H.Abowarda ◽  
Hosam N.Almassry
Keyword(s):  
Hepatocellular Carcinoma ◽  
Abdominal Pain ◽  
Progressive Disease ◽  
Tumour Response ◽  
Complete Response ◽  
Tace Group ◽  
Conventional Tace ◽  
Drug Eluting Beads ◽  
Drug Eluting ◽  
Arterial Chemoembolization

To compare tumour response and complications of conventional TACE with lipidol versus DEB-TACE in the treatment of non-resectable HCC.Prospective non randomized comparative clinical trial was performed for patients receiving TACE at interventional radiology unit in Radiodiagnosis department in Zagazig university hospitals. Forty patients were included in this study, 16 patients were treated with drug eluting beads TACE and 24 patients were treated with conventional TACE.Follow up triphasic CT was performed 1 month after the procedure, we found that complete response was 6 cases (25 %) in c TACE group, and 4 cases (25%) in drug eluting bead TACE group, Partial response was achieved in 11 cases (45.8%) in c TACE group, and in 8 cases (50 %) in DEBs-TACE group, Cases with stable disease were 5 cases (20.8%) in c TACE group, and it was 3 cases (18.7%) in DEBs-TACE group, progressive disease is noted in two cases (8.3 %) in c TACE group, and one case (6.2 %) in drug eluting TACE group. Complications were as follow: 18 cases (75%) with abdominal pain in c TACE group, and 6 cases (37.5%) with abdominal pain in DEBs-TACE group, Nausea and vomiting were noted in 13 cases (54.17%) in c TACE group and in 3 cases (18.75%)in DEBs TACE group, Alopecia was noted in 8 cases (33.3 %) in c TACE group and in one case (6.25%) in DEBs TACE group.There were no significant differences between two groups regarding tumour response after 1 month. Almost all complications were significantly lower in DEBs-TACE group than in c TACE group, especially with abdominal pain, nausea, vomiting and alopecia. Abbreviations: c TACE: conventional trans-arterial chemoembolization, DEB TACE: drug eluting beads trans-arterial chemoembolization, HCC: hepatocellular carcinoma, CR: complete response, PR: partial response, SD: stable disease, PD: progressive disease.

scholarly journals Aspirin Decreases Hepatocellular Carcinoma Risk in Hepatitis C Virus Carriers: A Nationwide Cohort Study

2019 ◽  
Author(s):  
Yen-Hsiang Liao ◽  
Ren-Jun Hsu ◽  
Tzu-Hwei Wang ◽  
Chen-Ta Wu ◽  
Sheng-Yao Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Incidence Rate ◽  
Control Group ◽  
Kaplan Meier ◽  
B Virus

Abstract Background Aspirin has been found to lower the occurrence rates of some cancers through the inhibition of the cyclooxygenase enzyme. For example, there is a well-known association between aspirin use and the occurrence of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) carriers. However, the association, if any, between aspirin use and HCC in hepatitis C virus (HCV) carriers is unknown. Therefore, this study compared the occurrence rates of HCC in HCV carriers treated with or without aspirin. Methods The participants in this retrospective cohort study consisted of people newly diagnosed with HCV in Taiwan from 2000 to 2012. Those who were treated with aspirin were defined as the control group, whereas those not treated with aspirin were defined as the comparison cohort. We used a 1:1 propensity score matching by age, sex, comorbidities, drugs, diagnosis year, and index year with covariate assessment. Results Our study sample consisted of 2980 aspirin-treated HCV carriers and 7771 non-aspirin-treated HCV carriers. After propensity score matching, each cohort consisted of 1911 HCV carriers. The adjusted hazard ratio (aHR) of HCC incidence in the aspirin users (aHR=0.56, 95% CI=0.43-0.72, p < 0.001 ) was significantly lower than that in the non-aspirin users. A Kaplan-Meier analysis showed that among the HCV carriers, the aspirin users had a lower cumulative incidence rate of HCC over the first 10 years of aspirin treatment ( p < 0.0001 ). Conclusions The HCC incidence rate was lower in the aspirin-using HCV carriers than in the non- aspirin-using HCV carriers, indicating that the effects of aspirin might occur through inhibition of the cyclooxygenase enzyme pathway. Moreover, protection from HCC was provided by less than a year of aspirin treatment, while treatment with aspirin for 1 to 2 years exhibited the greatest protective effect. We therefore encourage aspirin treatment to prevent HCC in HCV carriers.

scholarly journals Aspirin decreases hepatocellular carcinoma risk in hepatitis C virus carriers: a nationwide cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yen-Hsiang Liao ◽  
Ren-Jun Hsu ◽  
Tzu-Hwei Wang ◽  
Chen-Ta Wu ◽  
Sheng-Yao Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cohort Study ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Incidence Rate ◽  
Control Group ◽  
Kaplan Meier ◽  
B Virus

Abstract Background Aspirin has been found to lower the occurrence rates of some cancers through the inhibition of the cyclooxygenase enzyme. For example, there is a well-known association between aspirin use and the occurrence of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) carriers. However, the association, if any, between aspirin use and HCC in hepatitis C virus (HCV) carriers is unknown. Therefore, this study compared the occurrence rates of HCC in HCV carriers treated with or without aspirin. Methods The participants in this retrospective cohort study consisted of people newly diagnosed with HCV in Taiwan from 2000 to 2012. Those who were treated with aspirin were defined as the control group, whereas those not treated with aspirin were defined as the comparison cohort. We used a 1:1 propensity score matching by age, sex, comorbidities, drugs, diagnosis year, and index year with covariate assessment. Results Our study sample consisted of 2980 aspirin-treated HCV carriers and 7771 non-aspirin-treated HCV carriers. After propensity score matching, each cohort consisted of 1911 HCV carriers. The adjusted hazard ratio (aHR) of HCC incidence in the aspirin users (aHR = 0.56, 95% CI = 0.43–0.72, p < 0.001) was significantly lower than that in the non-aspirin users. A Kaplan-Meier analysis showed that among the HCV carriers, the aspirin users had a lower cumulative incidence rate of HCC over the first 10 years of aspirin treatment (p < 0.0001). Conclusions The HCC incidence rate was lower in the aspirin-using HCV carriers than in the non- aspirin-using HCV carriers, indicating that the effects of aspirin might occur through inhibition of the cyclooxygenase enzyme pathway. Moreover, protection from HCC was provided by less than a year of aspirin treatment, while treatment with aspirin for 1 to 2 years exhibited the greatest protective effect. We therefore encourage aspirin treatment to prevent HCC in HCV carriers.

scholarly journals Comparison of Transcatheter Arterial Chemoembolization-Radiofrequency Ablation and Transcatheter Arterial Chemoembolization Alone for Advanced Hepatocellular Carcinoma with Macrovascular Invasion Using Propensity Score Analysis: A Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Yao Liu ◽  
Yuxin Li ◽  
Fangyuan Gao ◽  
Qun Zhang ◽  
Xue Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Propensity Score ◽  
Transcatheter Arterial Chemoembolization ◽  
Propensity Score Analysis ◽  
Supportive Therapy ◽  
Control Group ◽  
Tumor Diameter ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterial Chemoembolization

Background. To compare the efficacies of transcatheter arterial chemoembolization (TACE) with radiofrequency ablation (RFA) (TACE + RFA) and TACE alone in patients with hepatocellular carcinoma (HCC) and macrovascular invasion (MVI). Methods. In total, 664 patients having HCC with MVI were included. Of these patients, 141 were treated with TACE + RFA, 254 with TACE alone, and 269 with supportive therapy (control group). The overall survival (OS) was compared among these groups. Propensity score matching (PSM) was performed for balancing the characteristics of the three groups. Results. After one-to-one PSM, the 12-month OS rates were higher in the TACE and TACE + RFA groups than in the control group (p=0.0009 and p=0.0017, respectively). Furthermore, higher 12-month OS rates were observed in the TACE + RFA group than in the TACE group (p=0.0192). The 12-month OS rates of patients were remarkably higher in α-fetoprotein (AFP) < 400 ng/ml, tumor < 3, tumor diameter < 5 cm, or portal vein tumor thrombosis (PVTT) group who were treated with TACE + RFA than in those who were treated with TACE (p=0.0122, p=0.0090, p=0112, and p=0.0071, respectively). Conclusions. TACE + RFA provides a superior survival outcome than TACE alone in HCC patients, especially in AFP <400 ng/ml, tumor <3, tumor diameter <5 cm, or PVTT group.

Is transcatheter arterial chemoembolization plus sorafenib better than chemoembolization plus placebo in the treatment of hepatocellular carcinoma?

2020 ◽  
pp. 030089162094502
Author(s):  
Yong Xie ◽  
Huan Tian ◽  
Hua Xiang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transcatheter Arterial Chemoembolization ◽  
Meta Analysis ◽  
Survival Rates ◽  
Complete Response ◽  
Cochrane Library ◽  
Control Group ◽  
Significant Difference ◽  
Grade 3 ◽  
Arterial Chemoembolization

Objective: To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) plus sorafenib compared with TACE plus placebo for hepatocellular carcinoma (HCC) using meta-analytical techniques. Methods: A search of PubMed, EMBASE, and Cochrane Library databases were done from inception to December 27, 2019. Published trials including a treatment group receiving TACE + sorafenib and a control group receiving TACE + placebo with data for at least 1-year survival or tumor response or time to progression were included. Results: Our study suggested that there was no evidence that TACE plus sorafenib was associated with a lower risk of disease progression compared with TACE plus placebo for treatment of HCC (hazard ratio 0.94 [95% confidence interval (CI), 0.84–1.05]), and no significant difference for treatment of HCC compared with TACE plus placebo in terms of 0.5-, 1-, 1.5-, and 2-year survival rates (risk ratio [RR] 1.01 [95% CI, 0.97–1.05]; RR 1.00 [95% CI, 0.92–1.08], RR 1.04 [95% CI, 0.89–1.23], RR 0.98 [95% CI, 0.72–1.34], respectively). The meta-analysis also showed that TACE + sorafenib seemed to have no significant difference for treatment of HCC compared with TACE + placebo in terms of complete response, partial response, stable disease, progressive disease, overall response rate, and disease control rate. There was an increased incidence of fatigue of grade 3/4 and elevation of aspartate aminotransferase and alanine aminotransferase of grade 3/4 in patients receiving TACE plus sorafenib compared with those receiving TACE plus placebo. Conclusions: There is no additive benefit of TACE plus sorafenib compared to TACE plus placebo for HCC.

Sign in / Sign up

Export Citation Format

Share Document