Oncology

Clinical Study

Increased Arterio-Portal Shunt Formation after Drug-Eluting Beads TACE for Hepatocellular Carcinoma

Shimose S.a · Iwamoto H.a,b · Tanaka M.c · Niizeki T.a · Shirono T.a · Nakano M.a · Okamura S.a · Noda Y.a · Kamachi N.a · Sakai M.a · Suzuki H.a · Nomiyama M.a · Kuromatsu R.a · Koga H.a · Torimura T.a

Author affiliations

aDivision of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
bIWAMOTO Medical Clinic, Kitakyusyu, Japan
cYokokura Hospital, Miyama, Japan

Keywords: Transcatheter arterial chemoembolizationEpirubicinDrug-eluting beadsHepatocellular carcinoma

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Oncology 2020;98:558–565
https://doi.org/10.1159/000507262

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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: February 06, 2020
Accepted: March 14, 2020
Published online: May 18, 2020
Issue release date: August 2020

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 3

ISSN: 0030-2414 (Print)
eISSN: 1423-0232 (Online)

For additional information: https://www.karger.com/OCL

Abstract

Background and Aims: Conventional transcatheter arterial chemoembolization (C-TACE) and drug-eluting bead (DEB)-based TACE are current treatments for hepatocellular carcinoma (HCC). We compared the therapeutic efficacies and adverse events of these methods in a single-center retrospective cohort study. Methods: We enrolled 174 patients treated between January 2010 and October 2016; 98 and 76 underwent C-TACE and DEB-TACE, respectively, with 76 and 22 of the former group and 49 and 27 of the latter group classified as Child-Pugh class A and B, respectively. Therapeutic outcomes, progression-free survival (PFS), and adverse events were evaluated. Results: The PFS rates in the C-TACE and DEB-TACE groups were 8.1 and 6.1 months, respectively (p = 0.79). The response and disease control rates were 64 and 71% in C-TACE patients and 69 and 78% in DEB-TACE patients, respectively (p = 0.25). Postprocedural pain, vomiting, and fever were more frequent following C-TACE than DEB-TACE (p < 0.001). In contrast, the incidences of bilomas and arterio-portal shunts were significantly higher following DEB-TACE (p < 0.001); the incident rates of arterio-portal shunt formation were 8.1 and 48.7% in patients undergoing C-TACE and DEB-TACE, respectively. Child-Pugh class A was significantly associated with arterio-portal shunt formation after DEB-TACE on multivariate analysis. Conclusions: There were no significant differences in the therapeutic efficacies of C-TACE and DEB-TACE. However, the frequency of arterio-portal shunt formation was significantly higher in HCC patients with Child-Pugh class A undergoing DEB-TACE. Our findings imply that C-TACE should be selected for HCC patients with Child-Pugh class A and DEB-TACE should be chosen for those with Child-Pugh class B.

© 2020 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Clinical Study

Received: February 06, 2020
Accepted: March 14, 2020
Published online: May 18, 2020
Issue release date: August 2020

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 3

ISSN: 0030-2414 (Print)
eISSN: 1423-0232 (Online)

For additional information: https://www.karger.com/OCL

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2020, Vol.98, No. 8

August 2020

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