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Liming Lu, Jingchun Zeng, Zehuai Wen, Chunzhi Tang, Nenggui Xu
BACKGROUND: Hepatocellular carcinoma, also called malignant hepatoma, is a primary malignancy of the liver. Despite regular surveillance conducted in high-risk populations, most people with hepatocellular carcinoma are diagnosed at an advanced stage. Consequently, only a minority of people with the disease are suitable for surgical resection when diagnosed. OBJECTIVES: To compare the beneficial and harmful effects of transcatheter arterial chemoembolisation (TACE) followed by three-dimensional conformal radiotherapy (3-DCRT) versus TACE alone in adults with primary hepatocellular carcinoma, considered unsuitable for surgical resection...
February 16, 2019: Cochrane Database of Systematic Reviews
Jorge Aramburu, Raúl Antón, Alejandro Rivas, Juan Carlos Ramos, Gorka S Larraona, Bruno Sangro, José Ignacio Bilbao
Balloon-occluded transarterial chemoembolisation (B-TACE) is an intraarterial transcatheter treatment for liver cancer. In B-TACE, an artery-occluding microballoon catheter occludes an artery and promotes collateral circulation for drug delivery to tumours. This paper presents a methodology for analysing the haemodynamics during B-TACE, by combining zero-dimensional and three-dimensional modelling tools. As a proof of concept, we apply the methodology to a patient-specific hepatic artery geometry and analyse two catheter locations...
February 7, 2019: Computer Methods in Biomechanics and Biomedical Engineering
M-C Ou, Y-S Liu, M-T Chuang, C-Y Lin, L-T Huang, C-Y Lin
AIMS: To identify the optimal transarterial chemoembolisation (TACE) approach in patients with large hepatocellular carcinoma (HCC; >5 cm) by comparing conventional TACE (cTACE) and drug-eluting-bead (DEB)-TACE. MATERIALS AND METHODS: This retrospective study included 63 consecutive HCC patients who received TACE at a single medical centre from September 2009 to October 2015. Primary endpoints were 3-year overall survival (OS) rate and time-to-progression (TTP)...
January 8, 2019: Clinical Radiology
Thomas Mules, Ed Gane, Oonagh Lithgow, Adam Bartlett, John McCall
AIM: Earlier diagnosis of hepatitis B virus (HBV) related hepatocellular carcinoma (HCC) increases treatment options and survival. The aim of this study is to evaluate which factors are associated with late presentation of HBV-related HCC. METHOD: This is a retrospective review of all cases of HBV-related HCC diagnosed with late-stage/incurable HCC in New Zealand between 2003 and 2017. Cases were defined as patients with a positive hepatitis B surface antigen (HBsAg), and advanced (not amenable to potentially curable treatments) HCC at initial diagnosis...
November 30, 2018: New Zealand Medical Journal
Jan Patrick Huber, Julia Lang, Robert Thimme, Arthur Schmidt, Dominik Bettinger
CLINICAL PRESENTATION: A 51-year-old male patient presented to our emergency department with fever, aggravating coughing and orthopnoea. Clinical evaluation revealed pneumonia in the right lower lobe of the lung and due to typical radiological hallmarks, aspiration pneumonia was suspected. During the last months, he had suffered from several pneumonias. The patient's history showed that he suffered from alveolar soft tissue sarcoma which was first diagnosed in 1985. He was treated with right-sided hemihepatectomy for resection of liver metastases, further liver resections, 12 sessions of radiation therapy and seven transarterial chemoembolisation sessions...
November 21, 2018: Gut
Guo Tian, Shigui Yang, Jinqiu Yuan, Diane Threapleton, Qiyu Zhao, Fen Chen, Hongcui Cao, Tian'an Jiang, Lanjuan Li
OBJECTIVE: Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide. We conducted network meta-regression within a Bayesian framework to compare and rank different treatment strategies for HCC through direct and indirect evidence from international studies. METHODS AND ANALYSES: We pooled the OR for 1-year, 3-year and 5-year overall survival, based on lesions of size ˂ 3 cm, 3-5 cm and ≤5 cm, using five therapeutic options including resection (RES), radiofrequency ablation (RFA), microwave ablation (MWA), transcatheter arterial chemoembolisation (TACE) plus RFA (TR) and percutaneous ethanol injection (PEI)...
October 18, 2018: BMJ Open
Mark Op den Winkel, Dorothea Nagel, Philip Op den Winkel, Philipp M Paprottka, Laura Schmidt, Hélène Bourhis, Jörg Trojan, Markus Goeller, Florian P Reiter, Stephanie-Susanne Stecher, Enrico N De Toni, Alexander L Gerbes, Frank T Kolligs
BACKGROUND/AIMS: The recently proposed Munich-transarterial chemoembolisation-score (M-TACE) was tailored to suit hepatocellular Carcinoma (HCC) patients evaluated for TACE. M-TACE outperformed the established HCC-staging-systems and successfully passed external validation. Modifications of staging-systems through the rearrangement of stages or by adding prognostic factors are methods of improving prognostic power. M-TACEs performance compared to scores modified this way should be tested...
October 3, 2018: Digestion
L Xiao, Q Liu, W Zhao, H Pang, Q Zeng, Y Chen, J Zhao, Q Mei, X He
AIM: To evaluate the efficacy and to identify prognostic factors of polyvinyl alcohol (PVA) chemoembolisation for treating advanced hepatocellular carcinoma (HCC) with portal vein (PV) tumour thrombosis (PVTT) and arterioportal shunts. MATERIALS AND METHODS: The clinical data of 145 advanced HCC patients with PVTT and arterioportal shunts were collected. The patients were divided into two groups: group A, with main PV invasion, (n=56) and group B, with PV branch invasion, (n=89)...
September 15, 2018: Clinical Radiology
Damian J Mole, Jonathan A Fallowfield, Timothy J Kendall, Fenella Welsh, Scott I Semple, Velicia Bachtiar, Matt Kelly, Stephen J Wigmore, O James Garden, Henry R Wilman, Rajarshi Banerjee, Myrddin Rees, Michael Brady
BACKGROUND: Accurate assessment of liver health prior to undertaking resectional liver surgery or chemoembolisation for primary and secondary cancers is essential for patient safety and optimal outcomes. LiverMultiScan™, an MRI-based technology, non-invasively quantifies hepatic fibroinflammatory disease, steatosis and iron content. We hypothesise that LiverMultiScan™can quantify liver health prior to surgery and inform the risk assessment for patients considering liver surgery or chemoembolization and seek to evaluate this technology in an operational environment...
September 12, 2018: BMC Cancer
Roberto Iezzi, Maurizio Pompili, Emanuele Rinninella, Eleonora Annicchiarico, Matteo Garcovich, Lucia Cerrito, Francesca Ponziani, AnnaMaria De Gaetano, Massimo Siciliano, Michele Basso, Maria Assunta Zocco, GianLodovico Rapaccini, Alessandro Posa, Francesca Carchesio, Marco Biolato, Felice Giuliante, Antonio Gasbarrini, Riccardo Manfredi
OBJECTIVES: To date, there is no approved second-line treatment for patients dismissing sorafenib or ineligible for this treatment, so it would be useful to find an effective alternative treatment option. The aim of our study was to evaluate safety, feasibility and effectiveness of transarterial chemoembolisation with degradable starch microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (sorafenib) due to unbearable side effects or clinical contraindications...
August 31, 2018: European Radiology
Dániel Deme, András Telekes
Since the therapeutic options for colon cancer are limited, the reinduction of treatments (rechallenge) is part of the therapeutic strategy. Our case is an example for that. A 65-year-old female patient was operated on stenotizing sigmoid cancer. Resectio was performed. Surgically incurable multiple hepatic metastases were proven. The histology revealed adenocarcinoma (grade II, pT3pN1cM1). In the first line, 13 cycles of bevacizumab (BEV) + FOLFOX followed by 2 cycles of BEV + capecitabine and 11 cycles of BEV + 5FU/LV were administered...
August 2018: Orvosi Hetilap
Yin Zhu, Pei-Jing Cui, Jing Yao, Zheng-Yun Zhang, Jun Yang
Objective: This study aimed at assessing the effects of transcatheter arterial chemoembolisation (TACE) and antiviral therapy on improving the prognosis of patients with hepatocellular carcinoma (HCC) after radical hepatectomy. Methods: This study reviewed the data of 120 patients with HCC who received either radical hepatectomy alone (control group), radical hepatectomy with postoperative TACE (TACE group) or radical hepatectomy with combined postoperative TACE, and antiviral therapy (combined group) from January 2000 to May 2015...
2018: Gastroenterology Research and Practice
J Y Yu, H P Zhang, Z Y Tang, J Zhou, X J He, Y Y Liu, X J Liu, D J Guo
AIM: To evaluate the potential value of texture analysis (TA) based on contrast-enhanced magnetic resonance imaging (MRI) for predicting an early response of patients with hepatocellular carcinoma (HCC) who were treated with transcatheter arterial chemoembolisation (TACE) combined with high-intensity focused ultrasound (HIFU). MATERIALS AND METHODS: Patients with HCC (n=89) who underwent contrast-enhanced MRI at 1.5 T 1 week before and 1 week, 1 month, and 3 months after TACE/HIFU were included in this retrospective study...
August 2018: Clinical Radiology
Jian Gao, Rui Zhen, Hai Liao, Wenquan Zhuang, Wenbo Guo
Numerous studies concerning hepatic arterial infusion chemotherapy (HAIC) have been conducted by adopting regimens containing 5-fluorouracil (FU), with a favourable efficacy compared with conventional transcatheter arterial chemoembolisation (TACE) treatment; however, the detailed mechanism of HAIC remains unclear. The present study aimed to evaluate peripheral concentration time curves of 5-FU administered through the hepatic artery, which may additionally explain the mechanism of action of HAIC. A total of 10 eligible patients underwent transcatheter arterial embolization and a 2-day HAIC treatment regimen using a folinic acid, fluorouracil and oxaliplatin regimen...
May 2018: Oncology Letters
Filomena Morisco, Silvia Camera, Maria Guarino, Raffaella Tortora, Valentina Cossiga, Anna Vitiello, Gabriella Cordone, Nicola Caporaso, Giovan Giuseppe Di Costanzo
Background: Limited therapies are available for large (≥40 mm) unresectable hepatocellular carcinoma (HCC). Currently, the standard treatment with transarterial chemoembolisation (TACE) is unsatisfactory with high recurrence rate and limited effect on survival. Laser Ablation (LA) has emerged as a relatively new technique characterized by high efficacy and good safety. This study is aimed to evaluate the efficacy of LA in comparison to TACE in patients with large HCC. Methods: Eighty-two patients with a single HCC nodule ≥40 mm (BCLC stage A or B) were enrolled in this case-control study...
April 3, 2018: Oncotarget
Aline Mähringer-Kunz, Arndt Weinmann, Irene Schmidtmann, Sandra Koch, Sebastian Schotten, Daniel Pinto Dos Santos, Michael Bernhard Pitton, Christoph Dueber, Peter Robert Galle, Roman Kloeckner
BACKGROUND: Transarterial chemoembolisation is the standard of care for intermediate stage (BCLC B) hepatocellular carcinoma, but it is challenging to decide when to repeat or stop treatment. Here we performed the first external validation of the SNACOR (tumour Size and Number, baseline Alpha-fetoprotein, Child-Pugh and Objective radiological Response) risk prediction model. METHODS: A total of 1030 patients with hepatocellular carcinoma underwent transarterial chemoembolisation at our tertiary referral centre from January 2000 to December 2016...
April 27, 2018: BMC Cancer
Sai Pavan Chintalapati, Arpan Patel, Hari Conjeevaram
Transarterial chemoembolisation (TACE) is commonly used for unresectable intermediate-stage hepatocellular carcinoma (HCC). TACE is usually well-tolerated. We report a case of a patient who presented with a gastrointestinal bleed from TACE. A 64-year-old man presented with chronic hepatitis C cirrhosis and multifocal bilobar HCC. He had previously undergone multiple TACE sessions, radiofrequency ablation and stereotactic body radiation therapy. In the evening of his TACE procedure, he developed abdominal pain and haematemesis...
February 21, 2018: BMJ Case Reports
Siobhra O'Sullivan, Daniel N Cagney
Primary and secondary malignancies of the liver and pancreas result in significant morbidity and mortality, with increasing incidence and increasing demands on health services worldwide. Surgery is the only curative single modality of treatment and remains the gold standard. Unfortunately, up to 80% of the patients present with unresectable disease, and so, alternative efficacious local and systemic treatments are needed. Technologic advances in radiotherapy over recent decades have meant that precision high-dose treatment with stereotactic body radiotherapy (SBRT) has emerged as a viable cost-effective outpatient-based treatment in the management of these difficult to treat abdominal malignancies...
November 2018: Irish Journal of Medical Science
Tim Sattler, Christina Bredt, Stefanie Surwald, Christian Rust, Johannes Rieger, Tobias Jakobs
BACKGROUND/AIM: To retrospectively evaluate the efficacy and safety of drug eluting bead (DEB) transarterial chemoembolisation (TACE) with microspheres <150 μm for the treatment of hepatocellular carcinoma (HCC) with respect to overall survival, progression-free survival, tumor response and the peri-interventional toxicity. MATERIALS AND METHODS: In this retrospective, single-center study we analyzed 32 HCC-patients (BCLC A: 10 patients, BCLC B: 17 patients, BCLC C: 5 patients), who were treated with (DEB) <15 μm (DCBeadM1®) loaded with epirubicin between 2011 and 2015...
February 2018: Anticancer Research
Sarah Degiorgio, Roberta Gerasia, Ferdinanda Liotta, Luigi Maruzzelli, Kelvin Cortis, Roberto Miraglia, Angelo Luca
PURPOSE: The primary aim of this study is to provide a summary of operators' radiation doses during hepatobiliary fluoroscopic guided procedures. In addition, patient dose in these procedures was also documented. MATERIALS AND METHODS: A total of 283 transarterial chemoembolisation (TACE) and 302 biliary procedures, including 52 percutaneous transhepatic cholangiogram (PTC), 36 bilioplasty and 214 biliary catheter changes (BCC) performed over 14 months, were included...
May 2018: Cardiovascular and Interventional Radiology
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