Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma

Comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study

Seungsoo Lee, Kyoung Min Kim, Shin Jae Lee, Kwang Hun Lee, Do Yun Lee, ManDeuk Kim, doyoung kim, Seungup Kim, Jong Yun Won

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Abstract

Background Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) frequently causes feeding artery stenosis or occlusion that may interfere with repeated treatment. Purpose To investigate the incidence and predictors of hepatic arterial damage (HAD) after drug-eluting bead-TACE (DEB-TACE) in comparison with conventional TACE (Conv-TACE). Material and Methods We retrospectively analyzed 54 patients who underwent DEB-TACE for HCC as an initial treatment with follow-up angiography and 54 patients who underwent Conv-TACE using doxorubicin-lipiodol mixture and gelfoam particles for comparison. HAD was evaluated after a single session of TACE and graded as follows: grade I, no significant wall irregularity; grade II, overt stenosis; grade III, occlusion. Results The incidence of HAD was significantly higher in the DEB-TACE group than the Conv-TACE group when analyzed per branch (odds ratio [OR], 6.36; P < 0.001) and per patient (OR, 3.15; P = 0.005). For each HAD grade, the mean doxorubicin dose was greater in the DEB-TACE group than in the Conv-TACE group (P < 0.001, P = 0.053, and P = 0.01 for grades I, II, and III, respectively). In multivariate analysis, risk factors of HAD included mean doxorubicin dose and selective embolization in the Conv-TACE group (P = 0.03 and P < 0.001, respectively) and mean doxorubicin dose in the DEB-TACE group (P = 0.004). Conclusion The incidence and grade of HAD were higher after DEB-TACE compared to Conv-TACE with doxorubicin dose as a possible risk factor. HAD was independent of overall survival in both groups.

Original languageEnglish
Pages (from-to)131-139
Number of pages9
JournalActa Radiologica
Volume58
Issue number2
DOIs
Publication statusPublished - 2017 Jan 1

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Hepatocellular Carcinoma
Retrospective Studies
Doxorubicin
Liver
Pharmaceutical Preparations
Therapeutics
Incidence
Pathologic Constriction
Odds Ratio
Absorbable Gelatin Sponge
Ethiodized Oil
Angiography
Multivariate Analysis
Arteries
Survival

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{9fceb01b09db463c9a0f53e11edee83c,
title = "Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma: Comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study",
abstract = "Background Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) frequently causes feeding artery stenosis or occlusion that may interfere with repeated treatment. Purpose To investigate the incidence and predictors of hepatic arterial damage (HAD) after drug-eluting bead-TACE (DEB-TACE) in comparison with conventional TACE (Conv-TACE). Material and Methods We retrospectively analyzed 54 patients who underwent DEB-TACE for HCC as an initial treatment with follow-up angiography and 54 patients who underwent Conv-TACE using doxorubicin-lipiodol mixture and gelfoam particles for comparison. HAD was evaluated after a single session of TACE and graded as follows: grade I, no significant wall irregularity; grade II, overt stenosis; grade III, occlusion. Results The incidence of HAD was significantly higher in the DEB-TACE group than the Conv-TACE group when analyzed per branch (odds ratio [OR], 6.36; P < 0.001) and per patient (OR, 3.15; P = 0.005). For each HAD grade, the mean doxorubicin dose was greater in the DEB-TACE group than in the Conv-TACE group (P < 0.001, P = 0.053, and P = 0.01 for grades I, II, and III, respectively). In multivariate analysis, risk factors of HAD included mean doxorubicin dose and selective embolization in the Conv-TACE group (P = 0.03 and P < 0.001, respectively) and mean doxorubicin dose in the DEB-TACE group (P = 0.004). Conclusion The incidence and grade of HAD were higher after DEB-TACE compared to Conv-TACE with doxorubicin dose as a possible risk factor. HAD was independent of overall survival in both groups.",
author = "Seungsoo Lee and Kim, {Kyoung Min} and Lee, {Shin Jae} and Lee, {Kwang Hun} and Lee, {Do Yun} and ManDeuk Kim and doyoung kim and Seungup Kim and Won, {Jong Yun}",
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Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma : Comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study. / Lee, Seungsoo; Kim, Kyoung Min; Lee, Shin Jae; Lee, Kwang Hun; Lee, Do Yun; Kim, ManDeuk; kim, doyoung; Kim, Seungup; Won, Jong Yun.

In: Acta Radiologica, Vol. 58, No. 2, 01.01.2017, p. 131-139.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma

T2 - Comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study

AU - Lee, Seungsoo

AU - Kim, Kyoung Min

AU - Lee, Shin Jae

AU - Lee, Kwang Hun

AU - Lee, Do Yun

AU - Kim, ManDeuk

AU - kim, doyoung

AU - Kim, Seungup

AU - Won, Jong Yun

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) frequently causes feeding artery stenosis or occlusion that may interfere with repeated treatment. Purpose To investigate the incidence and predictors of hepatic arterial damage (HAD) after drug-eluting bead-TACE (DEB-TACE) in comparison with conventional TACE (Conv-TACE). Material and Methods We retrospectively analyzed 54 patients who underwent DEB-TACE for HCC as an initial treatment with follow-up angiography and 54 patients who underwent Conv-TACE using doxorubicin-lipiodol mixture and gelfoam particles for comparison. HAD was evaluated after a single session of TACE and graded as follows: grade I, no significant wall irregularity; grade II, overt stenosis; grade III, occlusion. Results The incidence of HAD was significantly higher in the DEB-TACE group than the Conv-TACE group when analyzed per branch (odds ratio [OR], 6.36; P < 0.001) and per patient (OR, 3.15; P = 0.005). For each HAD grade, the mean doxorubicin dose was greater in the DEB-TACE group than in the Conv-TACE group (P < 0.001, P = 0.053, and P = 0.01 for grades I, II, and III, respectively). In multivariate analysis, risk factors of HAD included mean doxorubicin dose and selective embolization in the Conv-TACE group (P = 0.03 and P < 0.001, respectively) and mean doxorubicin dose in the DEB-TACE group (P = 0.004). Conclusion The incidence and grade of HAD were higher after DEB-TACE compared to Conv-TACE with doxorubicin dose as a possible risk factor. HAD was independent of overall survival in both groups.

AB - Background Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) frequently causes feeding artery stenosis or occlusion that may interfere with repeated treatment. Purpose To investigate the incidence and predictors of hepatic arterial damage (HAD) after drug-eluting bead-TACE (DEB-TACE) in comparison with conventional TACE (Conv-TACE). Material and Methods We retrospectively analyzed 54 patients who underwent DEB-TACE for HCC as an initial treatment with follow-up angiography and 54 patients who underwent Conv-TACE using doxorubicin-lipiodol mixture and gelfoam particles for comparison. HAD was evaluated after a single session of TACE and graded as follows: grade I, no significant wall irregularity; grade II, overt stenosis; grade III, occlusion. Results The incidence of HAD was significantly higher in the DEB-TACE group than the Conv-TACE group when analyzed per branch (odds ratio [OR], 6.36; P < 0.001) and per patient (OR, 3.15; P = 0.005). For each HAD grade, the mean doxorubicin dose was greater in the DEB-TACE group than in the Conv-TACE group (P < 0.001, P = 0.053, and P = 0.01 for grades I, II, and III, respectively). In multivariate analysis, risk factors of HAD included mean doxorubicin dose and selective embolization in the Conv-TACE group (P = 0.03 and P < 0.001, respectively) and mean doxorubicin dose in the DEB-TACE group (P = 0.004). Conclusion The incidence and grade of HAD were higher after DEB-TACE compared to Conv-TACE with doxorubicin dose as a possible risk factor. HAD was independent of overall survival in both groups.

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