Article Sidebar
Views PDF: 88
Transarterial embolization for the treatment of arterioportal shunts in patients with hepatocellular carcinoma: a short-term efficacy and safety study
Main Article Content
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.
Article Details
Keywords
Hepatocellular carcinoma (HCC)., Transarterial chemoembolization (TACE), Arterioportal shunts (APS)
References
2. Huang M-S, Lin Q, Jiang Z-B, et al. Comparison of long-term effects between intra-arterially delivered ethanol and Gelfoam for the treatment of severe arterioportal shunt in patients with hepatocellular carcinoma. World J Gastroenterol. 2004;10(6):825.
3. Luo M, Shan H, Jiang Z, Li L, Huang H, Zhang J. Study of the capability of multislice CT to diagnose arterioportal shunt in hepatocellular carcinoma. Chinese J Clin Oncol. 2004;1(5):312-316.
4. Wu H, Zhao W, Zhang J, Han J, Liu S. Clinical characteristics of hepatic Arterioportal shunts associated with hepatocellular carcinoma. BMC Gastroenterol. 2018;18(1):1-6.
5. Yeo JK, Hae GL, Jeong MP, et al. Polyvinyl alcohol embolization adjuvant to oily chemoembolization in advanced hepatocellular carcinoma with arterioportal shunts. Korean J Radiol. 2007;8(4):311-319. doi:10.3348/ kjr.2007.8.4.311
6. Vogl TJ, Nour-Eldin N-E, Emad-Eldin S, et al. Portal vein thrombosis and arterioportal shunts: effects on tumor response after chemoembolization of hepatocellular carcinoma. World J Gastroenterol WJG. 2011;17(10):1267.
7. Duan F, Bai Y, Cui L, Li X, Yan J, Zhu H. Transarterial embolization with N-butyl 2-cyanoacrylate for the treatment of arterioportal shunts in patients with hepatocellular carcinoma. J Cancer Res Ther. 2017;13(4):631.
8. Shi H Bin, Yang ZQ, Liu S, et al. Transarterial embolization with cyanoacrylate for severe arterioportal shunt complicated by hepatocellular carcinoma. Cardiovasc Intervent Radiol. 2013;36(2):412-421. doi:10.1007/s00270-012-0410-4