Transarterial embolization for the treatment of arterioportal shunts in patients with hepatocellular carcinoma: a short-term efficacy and safety study

Dr Dang Ngoc Hieu1, Professor Pham Minh Thong1, Dr Trinh Hà Chau1, Dr Le Van Khang1, Dr Vu Dang Luu1
1 Radiology Center BV Bach Mai

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Abstract

Advanced stage hepatocellular carcinoma with arterioportal shunts has worse prognosis and limited treatment. Transarterial
chemoembolization (TACE) use embolic materials is a safe method and have efficacy in treatment.
Aims: The aim of this study is to evaluate safety and efficacy of transarterial chemoembolization (TACE) with use embolic materials for the treatment of hepatocellular carcinoma (HCC) with arterioportal shunts (APS)
Materials and Methods: From June 2019 to June 2020, 37 patients who had diagnosis of HCC with major portal vein thrombosis were perfomed TACE with diffrent embolic materials which depend on the level of APSs. The patients were followed after treatment 1 week for the clinical symptom and at 1-3 month after the initial intervention, contrast-enhannced multi slide computed tomography (MSCT) or magnetic resonance image (MRI) or DSA was performed to assess the APS’s treatment efficacy and tumor response by mRECIST and tumor markers (AFP or PIVKA-II). The primary safety endpoint was liver
toxicity at 2-5 days and 1 month after intervention.
Results: All interventional procedures were successful without any procedure relevant complications. The immediate APS improvement rate was 89.2% (33/37), and the APS improvement rate at first‑time follow‑up was 70.3% (26/37). Radiologically confirmed complete response (CR), partial response, stable disease, and progressive disease at 1 month after first chemoembolization were observed in 3 (8.1%), 17 (45.9%), 13 (35.1%) và 4 (10.9%) patients, respectively.
Conclusions: Transarterial chemoembolization (TACE) use embolic materials is safety and have efficacy in treatmen of arterioportal shunt in patient with hepatocellular carcinoma.

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References

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