Safety and efficacy of drug-eluting microspheres chemoembolization under cone beam computed tomography control in patients with early and intermediate stage hepatocellular carcinoma
, , , , , , and | Aug 14, 2022
About this article
Article Category: research article
Published Online: Aug 14, 2022
Page range: 311 - 318
Received: Dec 19, 2021
Accepted: Mar 31, 2022
DOI: https://doi.org/10.2478/raon-2022-0019
© 2022 Spela Korsic, Nastja Levasic, Rok Dezman, Lara Anja Lesnik Zupan, Blaz Trotovsek, Rado Jansa, Alojz Smid, Peter Popovic, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1
Minor complications after drug-eluting microsphere transarterial chemoembolization (DEM-TACE) in the study population
| Complications | Number of procedures (%) |
|---|---|
| Chest pain | 4 (0.9) |
| Pain in the right shoulder | 1 (0.2) |
| Hematoma puncture site at the | 3 (0.7) |
| Gastric erosions | 2 (0.4) |
| Intraprocedural branch rupture small arterial | 1 (0.2) |
Hepatocellular carcinoma (HCC) treatment prior to initial doxorubicin-loaded drug-eluting microsphere transarterial chemoembolization (DEM-TACE)
| Treatment | Number of patients (%) |
|---|---|
| No previous treatment | 120 (83.0) |
| cTACE | 2 (1.4) |
| Surgical resection | 13 (9.3) |
| Transplantation | 1 (0.7) |
| Surgical resection and RFA | 1 (0.7) |
| Surgical resection and cTACE | 1 (0.7) |
| RFA | 2 (1.4) |
| MWA | 1 (0.7) |
| ECT | 3 (2.1) |
Patient characteristics at baseline
| Gender, number of patients (%) | |
|---|---|
| Male/Female | 127 (88.2)/17 (11.8) |
| Mean ± SD | 67.9 ± 8 |
| Number median of (range) lesions per patient, | 3 (1–10) |
| Bilobar, n. (%) | 52 (36.1) |
| Unilobar, n. (%) | 92 (63.9) |
| Right lobe, n. (%) | 71 (49.3) |
| Left lobe, n. (%) | 21 (14.6) |
| Yes/No | 76 (52.8)/68 (47.2) |
| Yes/No | 34 (23.6)/110 (76.4) |
| Yes/No | 120 (83.3)/24 (16.7) |
| Alcohol | 63 (52.5) |
| HBV | 16 (13.3) |
| HCV | 14 (11.6) |
| Primary biliary cirrhosis | 2 (1.8) |
| Other | 25 (20.8) |
| 5.7 ± 0.8 | |
| A/B | 91 (75.8)/29 (24.2) |
| A/B | 50(34.7)/94 (65.3) |
| Albumin, [g/l] | 39.5 (28–50) |
| Total bilirubin, [μmol/l] | 18 (5–83) |
| AFP, [ng/ml] | 14.4 (1.1–12809.8) |
| AST, [μkat/l] | 0.82 (0.35–3.29) |
| GGT, [μkat/l] | 1.77 (0.25–24.95) |
| Creatinine, [μmol/l] | 78 (39.0–148.0) |
Inclusion and exclusion criteria (Child-Pugh; CP)
| early-stage HCC patients ineligible for resection, transplantation or ablation; intermediate-stage HCC patients with a CP score of A or B (up to 7 points); treatment with DEM-TACE under cone beam CT control. | |
| DEM-TACE prior to liver transplantation; inability of regular follow-up. |
Overall survival after DEM-TACE in the study population Senči polja med vrsticami
| Factor | Number of patients | Median survival | 95% CI | |
|---|---|---|---|---|
| Child-Pugh A | 91 | 26.6 | 17.7–35.5 | 0.008 |
| Child-Pugh B | 29 | 19.6 | 18.4–20.8 | |
| Portal hypertension | 76 | 20.2 | 14.7–25.7 | 0.001 |
| No portal hypertension | 68 | 32.4 | 24.0–40.8 | |
| Ascites | 34 | 19.6 | 15.3–23.9 | 0.016 |
| No ascites | 110 | 29 | 23.0–35.0 | |
| Unilobar disease | 92 | 24.9 | 21.0–28.8 | 0.609 |
| Bilobar disease | 52 | 26.3 | 21.5–31.1 |