scholarly journals Predictive Factors for the Effectiveness of Repeated Lines of Transarterial Chemoembolization in the Treatment of Localized Hepatocellular Carcinoma

2021 ◽  
Vol 4 (1) ◽  
pp. 42-52
Author(s):  
V. V. Breder ◽  
M. Y. Pitkevich ◽  
V. Y. Kosirev ◽  
B. I. Dolgushin ◽  
E. R. Virshke ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Disease Progression ◽  
Predictive Factors ◽  
Transarterial Chemoembolization ◽  
Local Progression ◽  
The World ◽  
Intrahepatic Tumor

Hepatocellular carcinoma (HCC) remains the fourth leading cause of cancer-related death in the world. The progression of HCC after previously effective TACE is quite often local. This article describes our experience with repeated TACE in patients with local progression of HCC. We analyzed 125 patients with HCC, for the period from 2009 to 2015. TACE was performed for intrahepatic manifestations of HCC. Progression of HCC after TACE-1 was observed in 88.8 % (n = 111) patients. Disease progression after TACE‑2 was registered in 40 (32 %) patients. TACE‑3 was performed in 8 (6.4 %) patients. The analysis showed that isolated local intrahepatic progression of HCC with the growth of intrahepatic tumor nodes previously subjected to TACE‑1 (without new foci) does not affect OS. The efficiency of re-embolization (TACE‑2) is somewhat lower than for TACE of the first stage. Independent factors of overall survival increase in patients receiving TACE: satisfactory objective status according to ECOG, efficacy of the first stage of TACE, late progression and objective effect after re-embolization. 

scholarly journals Transarterial Chemoembolization (TACE) Combined with Sorafenib in Treatment of HBV Background Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: A Propensity Score Matching Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jia Yuan ◽  
Xin Yin ◽  
Bei Tang ◽  
Hui Ma ◽  
Lan Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Propensity Score ◽  
Combination Therapy ◽  
Portal Vein ◽  
Propensity Score Matching ◽  
Transarterial Chemoembolization ◽  
Tumor Thrombus ◽  
Portal Vein Tumor Thrombus ◽  
Rank Test

Objectives. Hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) remains a challenge in management. Transarterial chemoembolization (TACE) has been used for patients with PVTT but efficiency was limited with a median overall survival of 4 to 6.1 months. The aim of this study is to evaluate the efficiency of TACE combined with sorafenib in HBV background HCC with PVTT. Methods. A total of 498 patients were enrolled in the study including 69 patients who received TACE combined with sorafenib and 429 patients treated with TACE alone between January 1st, 2008, and April 30st, 2014. Using the 1:2 propensity score matching, 138 well-balanced patients were enrolled. Overall survival (OS) was compared between the two groups. The Kaplan-Meier method was used to evaluate the OS, and the differences between groups were analyzed with a log-rank test. Results. TACE combined with sorafenib improved the OS of the patients compared with TACE alone (13.0 vs 6.0 months, p<0.001). After propensity score matching, the median OS of combination therapy and TACE were 13.0 and 7.0 months, respectively (p=0.001). Subgroup analysis revealed that the patients younger than 60 years old, male patients, AFP more than 400ng/ml, tumor size more than 5cm, or type III/IV PVTT had OS benefits from TACE combined with sorafenib. Conclusions. Compared with TACE therapy alone, TACE combined with sorafenib could improve OS in HBV background HCC patients with PVTT. The patients who are younger, male, or with more tumor burden may benefit more from combination therapy.

ART Score and Predictive Factors of Prognosis in Hepatocellular Carcinoma Patients Treated With Transarterial Chemoembolization

2014 ◽  
Vol 109 ◽  
pp. S152
Author(s):  
Helder Cardoso ◽  
Filipe Vilas-Boas ◽  
Margarida Marques ◽  
Carlos Soares ◽  
Renato Melo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Factors ◽  
Transarterial Chemoembolization

Efficacy and safety of anti-VEGF therapy in metastatic unresectable hepatocellular carcinoma: A meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15632-e15632
Author(s):  
Lakshmi Manogna Chintalacheruvu ◽  
Avanija Buddam ◽  
Arun Kanmanthareddy ◽  
Apar Kishor Ganti
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Adverse Effects ◽  
Disease Progression ◽  
Meta Analysis ◽  
Categorical Variables ◽  
Vegf Receptor ◽  
Efficacy And Safety ◽  
Unresectable Hepatocellular Carcinoma ◽  
Significant Difference

e15632 Background:Conventional chemotherapy has limited role in metastatic unresectable hepatocellular carcinoma (HCC). Sorafenib is currently approved for metastatic unresectable HCC. We wanted to assess the efficacy and safety of other tyrosine kinase inhibitors (TKI) targeting vascular endothelial growth factor (VEGF) receptor such as brivanib, linifanib and regorafenib in metastatic HCC. Methods: We have searched electronic databases Pubmed, Google scholar to identify published trials using brivanib, linifanib and regorafenib in HCC. The outcomes evaluated were overall survival, time to disease progression (TTDP) and adverse effects. Hazard ratios (HR) with their respective 95% confidence intervals (CI) were then computed using the appropriate model for categorical variables. We used STATA 13.0 and Comprehensive Meta Analysis 2.0 software for all analyses. Results: We included seven randomized control studies. A combined analysis of these seven randomised control trials showed improved overall survival (OS) in VEGF-TKI group when compared to placebo HR - 0.79; (95% CI 0.62-1.00). However, there was no significant survival benefit of the newer VEGF receptor inhibitors when compared to sorafenib (HR - 1.05; 95% CI 0.95-1.17). The time to disease progression (TTDP) was significantly better in VEGF-TKI group as compared to placebo (HR - 0.61; 95% CI 0.39-0.97). However, there was no significant difference in TTDP between VEGF-TKI group and Sorafenib (HR - 0.88; 95% CI 0.66-1.16). Adverse effects were noted to be higher in VEGF-TKI group when compared to placebo (HR- 1.07; 95% CI 1.01-1.13). Conclusions: Treatment with TKI targeting VEGF receptor is associated with a significant improvement in OS and TTDP with tolerable side effect profile. Inhibiting the VEGF receptor pathway could lead to improved outcomes in HCC.

scholarly journals Liver MRI and clinical findings to predict response after drug eluting bead transarterial chemoembolization in hepatocellular carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeong Yeop Lee ◽  
Byung Chan Lee ◽  
Hyoung Ook Kim ◽  
Suk Hee Heo ◽  
Sang Soo Shin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Predictive Factors ◽  
Transarterial Chemoembolization ◽  
Signal Intensity ◽  
Elevated Serum ◽  
Disease Free Survival ◽  
Hepatobiliary Phase ◽  
Mri Features ◽  
Drug Eluting

AbstractTo identify the gadoxetic acid (GA)-enhanced magnetic resonance imaging (MRI) and laboratory findings that enable prediction of treatment response and disease-free survival (DFS) after the first session of drug eluting bead transarterial chemoembolization (DEB-TACE) in patients with hepatocellular carcinoma (HCC). A total of 55 patients who underwent GA-enhanced MRI and DEB-TACE from January 2014 to December 2018 were included. All MRI features were reviewed by two radiologists. Treatment response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors. Univariate and multivariate logistic regression analyses were used to determine predictive factors of treatment response and DFS, respectively. A total of 27 patients (49.1%) achieved complete response (CR) after one session of treatment. There were no significant differences between the two groups in terms of clinical and laboratory characteristics. Heterogeneous signal intensity in the hepatobiliary phase (HBP) was the only independent predictor of non-CR (odds ratio, 4.807; p = 0.048). Recurrent HCC was detected in 19 patients (70.4%) after CR. In the multivariate analysis, elevated serum alpha-fetoprotein (AFP) level (≥ 30 ng/mL) was the only significant parameter associated with DFS (hazard ratio, 2.916; p = 0.040). This preliminary study demonstrated that heterogeneous signal intensity in the HBP and high serum AFP were useful predictive factors for poor treatment response and short DFS after DEB-TACE, respectively.

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