Transcatheter arterial embolization with only particles for the treatment of unresectable hepatocellular carcinoma Journal Article
| Authors: | Maluccio, M. A.; Covey, A. M.; Porat, L. B.; Schubert, J.; Brody, L. A.; Sofocleous, C. T.; Getrajdman, G. I.; Jarnagin, W.; DeMatteo, R.; Blumgart, L. H.; Fong, Y.; Brown, K. T. |
| Article Title: | Transcatheter arterial embolization with only particles for the treatment of unresectable hepatocellular carcinoma |
| Abstract: | Purpose: To determine the survival of patients with hepatocellular carcinoma (HCC) treated with a standardized method of transcatheter arterial embolization (TAE) with small embolic particles intended to impart terminal vessel blockade, and to evaluate prognostic factors that impact overall survival. Materials and Methods: A total of 322 patients with HCC who underwent 766 embolizations from January 1997 to December 2004 were retrospectively reviewed. Selective embolization of vessels feeding individual tumors was performed with small (50 μm) polyvinyl alcohol or spherical embolic particles (40-120 μm) intended to cause terminal vessel blockade. Repeat embolization was performed in cases of evidence of persistent viable tumor or development of new lesions. Patient, tumor, and treatment characteristics were prospectively recorded and tested for prognostic significance by univariate and multivariate analysis. Results: The median survival time was 21 months, with 1-, 2-, and 3-year overall survival rates of 66%, 46%, and 33%, respectively. In patients without extrahepatic disease or portal vein involvement by tumor, the overall 1-, 2-, and 3-year survival rates increased to 84%, 66%, and 51%, respectively. Okuda stage, extrahepatic disease, diffuse disease (≥5 tumors), and tumor size were independent predictors of survival on multivariate analysis. There were 90 complications (11.9%) in 75 patients, including eight deaths (2.5%), within 30 days of embolization. Conclusions: Hepatic arterial embolization with small particles to cause terminal vessel blockade is an effective treatment method for patients with unresectable HCC. These data support our hypothesis that particles alone may be the critical component of catheter-directed embolotherapy. © 2008 SIR. |
| Keywords: | adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; overall survival; artificial embolism; carcinoma, hepatocellular; liver neoplasms; outcome assessment; magnetic resonance imaging; tumor volume; tomography, x-ray computed; retrospective study; prediction; cancer mortality; liver carcinoma; survival time; cancer size; inoperable cancer; embolization, therapeutic; angiography; particle size; polyvinyl alcohol; microspheres; nanosphere |
| Journal Title: | Journal of Vascular and Interventional Radiology |
| Volume: | 19 |
| Issue: | 6 |
| ISSN: | 1051-0443 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2008-06-01 |
| Start Page: | 862 |
| End Page: | 869 |
| Language: | English |
| DOI: | 10.1016/j.jvir.2008.02.013 |
| PUBMED: | 18503900 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 28" - "Export Date: 17 November 2011" - "CODEN: JVIRE" - "Source: Scopus" |
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