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Identification of predictive factors for post-transarterial chemoembolization liver failure in hepatocellular carcinoma patients: A retrospective study

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World Journal of Clinical Cases 2022年第24期10卷 8535-8546页

作者： Min Yuan Tian-You Chen Xiao-Rong Chen Yun-Fei Lu Jia Shi Wen-Si Zhang Chen Ye Bo-Zong Tang Zong-Guo Yang Department of Interventional Medicine Shanghai Public Health Clinical CenterFudan UniversityShanghai 201508China Department of Integrative Medicine Shanghai Public Health Clinical CenterFudan UniversityShanghai 201508China Department of Internal Medicine of Traditional Chinese Medicine Shanghai East HospitalTongji University School of MedicineShanghai 201200China

BACKGROUND Post-transarterial chemoembolization(TACE)liver failure occurs frequently in hepatocellular carcinoma(HCC)*** identification of predictors for post-TACE liver failure is of great importance for clinical decision-making in this *** To investigate the occurrence rate and predictive factors of post-TACE liver failure in this retrospective study to provide clues for decision-making regarding TACE procedures in HCC *** The clinical records of HCC patients treated with TACE therapy were *** clinical characteristics and laboratory parameters of these patients were *** models were used to identify candidates to predict post-TACE liver *** A total of 199 HCC patients were enrolled in this study,and 70 patients(35.2%)developed post-TACE liver *** and multivariate logistic models indicated that microspheres plus gelatin embolization and main tumor size>5 cm were risk predictors for post-TACE liver failure[odds ratio(OR):4.4,95%confidence interval(CI):1.2-16.3,P=0.027;OR:2.3,95%CI:1.05-5.3,P=0.039,respectively].Conversely,HCC patients who underwent tumor resection surgery before the TACE procedure had a lower risk for post-TACE liver failure(OR:0.4,95%CI:0.2-0.95,P=0.039).CONCLUSION Microspheres plus gelatin embolization and main tumor size might be risk factors for post-TACE liver failure in HCC patients,while prior tumor resection could be a favorable factor reducing the risk of post-TACE liver failure.

关键词： transarterial chemoembolization Liver failure Hepatocellular carcinoma Embolization Tumor size

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Efficacy of dexamethasone and N-acetylcysteine combination in preventing post-embolization syndrome after transarterial chemoembolization in hepatocellular carcinoma

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World Journal of Gastroenterology 2023年第5期29卷 890-903页

作者： Nitipon Simasingha Wasu Tanasoontrarat Torpong Claimon Supatsri Sethasine Department of Internal Medicine Navamindradhiraj UniversityBangkok 10300Thailand Department of Radiology Navamindradhiraj UniversityBangkok 10300Thailand

BACKGROUND Conventional transarterial chemoembolization(cTACE)is the current standard treatment for intermediate-stage hepatocellular carcinoma(HCC).Postembolization syndrome(PES)is complex clinical syndrome that presents as fever,abdominal pain,nausea,and *** dexamethasone(DEXA)or Nacetylcysteine(NAC)is used to prevent PES;however,the synergistic effect of their combined therapy for preventing PES and liver decompensation has not been *** To evaluate the efficacy of DEXA and NAC combination in preventing PES and liver decompensation after *** Patients with Barcelona Clinic Liver Cancer stage A or B HCC who were scheduled for TACE were prospectively *** patients were randomly stratified to receive NAC and DEXA or *** dual therapy(NAC+DEXA)group received intravenous administration of 10 mg DEXA every 12 h,NAC 24 h prior to cTACE(150 mg/kg/h for 1 h followed by 12.5 mg/kg/h for 4 h),and a continuous infusion of 6.25 mg/h NAC plus 4 mg DEXA every 12 h for 48 h after *** placebo group received an infusion of 5%glucose solution until 48 h after *** was defined by South West Oncology Group toxicity code grading of more than 2 that was calculated using incidence of fever,nausea,vomiting,and *** One-hundred patients were enrolled with 50 patients in each *** of PES was significantly lower in the NAC+DEXA group compared with in the placebo group(6%vs 80%;P<0.001).Multivariate analysis showed that the dual treatment is a protective strategic therapy against PES development[odds ratio(OR)=0.04;95%confidence interval(CI):0.01-0.20;P<0.001).Seven(14%)patients in the placebo group,but none in the NAC+DEXA group,developed post-TACE liver decompensation.A dynamic change in Albumin-Bilirubin score of more than 0.5 point was found to be a risk factor for post-TACE liver decompensation(OR=42.77;95%CI:1.01-1810;P=0.049).CONCLUSION Intravenous NAC+DEXA administration ameliorated the occurrence of PES

关键词： Hepatocellular carcinoma Post-embolization syndrome transarterial chemoembolization Liver decompensation

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transarterial chemoembolization plus stent placement for hepatocellular carcinoma with main portal vein tumor thrombosis:A meta-analysis

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World Journal of Clinical Oncology 2024年第3期15卷 447-455页

作者： Wei-Fan Sui Jian-Yun Li Jian-Hua Fu Department of Interventional Radiology Zhenjiang First People's HospitalZhenjiang 212000Jiangsu ProvinceChina

BACKGROUND Portal vein tumor thrombus is an important indicator of poor prognosis in patients with hepatocellular *** chemoembolization is recommended as the standard first-line therapy for unresectable hepatocellular *** vein stent placement is a safe and effective therapy for promptly restoring flow and relieving portal hypertension caused by tumor *** To assess the clinical significance of transarterial chemoembolization plus stent placement for the treatment of hepatocellular carcinoma with main portal vein tumor *** We searched English and Chinese databases,assessed the quality of the included studies,analyzed the characteristic data,tested heterogeneity,explored heterogeneity,and tested publication *** In total,eight clinical controlled trials were *** results showed that the pressure in the main portal vein after stent placement was significantly lower than that with no stent *** cumulative stent patency and survival rates at 6 and 12 months were lower in the transarterial chemoembolization+stent placement group than in the transarterial chemoembolization+stent placement+brachytherapy/radiotherapy *** survival rates of patients treated with transarterial chemoembolization+stent placement for 6 and 12 months were higher than those of patients treated with transarterial chemoembolization *** For Chinese patients with hepatocellular carcinoma with main portal vein tumor thrombosis,transarterial chemoembolization plus stenting is *** chemoembolization+stent placement is more effective than transarterial chemoembolization *** chemoembolization+stent placement+brachytherapy/radiotherapy is more effective than transarterial chemoembolization+stenting.

关键词： Hepatocellular carcinoma transarterial chemoembolization Portal vein tumor thrombus Stent Meta-analysis

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Development of a computed tomography-based radiomics nomogram for prediction of transarterial chemoembolization refractoriness in hepatocellular carcinoma

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World Journal of Gastroenterology 2021年第2期27卷 189-207页

作者： Xiang-Ke Niu Xiao-Feng He Department of Interventional Radiology Nanfang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Interventional Radiology Affiliated Hospital of Chengdu UniversityChengdu 610081Sichuan ProvinceChina

BACKGROUND Some patients with hepatocellular carcinoma(HCC)are more likely to experience disease progression despite continuous transarterial chemoembolization(TACE),which is called TACE *** present,it is still difficult to predict TACE refractoriness,although some models/scoring systems have been *** present,radiological-based radiomics models have been successfully applied to predict cancer patient *** To develop and validate a computed tomography(CT)-based radiomics nomogram for the pre-treatment prediction of TACE *** This retrospective study consisted of a training dataset(n=137)and an external validation dataset(n=81)of patients with clinically/pathologically confirmed HCC who underwent repeated TACE from March 2009 to March *** features were retrospectively extracted from preoperative CT images of the arterial *** pre-treatment radiomics signature was generated using least absolute shrinkage and selection operator Cox regression analysis.A CT-based radiomics nomogram incorporating clinical risk factors and the radiomics signature was built and verified by calibration curve and decision curve *** usefulness of the CT-based radiomics nomogram was assessed by Kaplan-Meier curve *** used the concordance index to conduct head-to-head comparisons of the radiomics nomogram with the other four models(Assessment for Retreatment with transarterial chemoembolization score;α-fetoprotein,Barcelona Clinic Liver Cancer,Child-Pugh,and Response score;CT-based radiomics signature;and clinical model).All analyses were conducted according to the transparent reporting of a multivariable prediction model for individual prognosis or diagnosis *** The median duration of follow-up was 61.3 mo(interquartile range,25.5-69.3 mo)for the training cohort and 67.1 mo(interquartile range,32.4-71.3 mo)for the validation *** median number of TACE sessions was 4(range,3-7)in both cohorts.E

关键词： Hepatocellular carcinoma transarterial chemoembolization Refractoriness Radiomics Nomogram Computed tomography

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transarterial administration of integrin inhibitor loaded nanoparticles combined with transarterial chemoembolization for treating hepatocellular carcinoma in a rat model

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World Journal of Gastroenterology 2016年第21期22卷 5042-5049页

作者： Jun Qian Elsie Oppermann Andreas Tran Ulli Imlau Kun Qian Thomas Josef Vogl Department of Radiology Union Hospital Huazhong University of Science and Technology Institute for Diagnostic and Interventional Radiology Johann Wolfgang Goethe University

AIM: To compare the effect of transarterial chemoembolization(TACE) plus GRGDSP(Gly-Arg-Gly-Asp-SerPro, integrin-inhibitor) loaded nanoparticles with TACE alone or TACE + GRGDSP in a rat model of liver tumor. METHODS: Morris hepatoma 3924 A tumors were implanted in the livers of 30 ACI rats. The ACI rats were divided randomly into three groups(10 animals each). Tumor volume before treatment(V1) was examined by magnetic resonance imaging(MRI), and then, after laparotomy and placement of a PE-10 catheter into the hepatic artery, the following interventional protocols were performed: TACE(mitomycin C + lipiodol + degradable starch microspheres) + GRGDSP loaded nanoparticles for group A; TACE + GRGDSP for group B(control group 1); TACE alone for group C(control group 2). Tumor volume(V2) was assessed by MRI and the mean ratio of the post-treatment to pretreatment tumor volumes(V2/V1) was calculated. Immunohistochemical analysis was performed to assess the quantification of matrix metalloprotein 9(MMP-9) and vascular endothelial growth factor(VEGF) positive tumor cells in each treatment ***: The mean tumor growth ratios(V2/V1) were 1.3649 ± 0.1194 in group A, 2.0770 ± 0.1595 in group B, and 3.2148 ± 0.1075 in group C. Compared with groups B and C, group A showed a significant reduction in tumor volume. Lower expression of MMP-9 and VEGF in hepatocellular carcinoma was observed in group A than in groups B and C. The angiogenesis of tumor was evaluated using anti-VEGF antibodies, and the metastasis of tumor was assessed using antiMMP-9 antibody. MMP-9 and VEGF were expressed in all specimens. The immunoexpression of these proteins was confirmed by the presence of red cytoplasmic staining in tumor cells. Lower expression of MMP-9 and VEGF in hepatocellular carcinoma was observed in group A than in groups B and ***: transarterial administration of integrin inhibitor loaded nanoparticles combined with TACE evidently retards tumor growth and intrahepatic met

关键词： Hepatocellular carcinoma transarterial chemoembolization Integrin inhibitor Nanoparticles Matrix metalloprotein 9 Vascular endothelial growth factor ACI rats

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Chemotherapy for transarterial chemoembolization in patients with unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第31期20卷 10960-10968页

作者： Jie Wu Lei Song Dan-Yi Zhao Bing Guo Jing Liu Department of Medical Oncology the Second Hospital of Dalian Medical University

AIM: To compare the efficacy of different chemotherapeutic agents during conventional transarterial chemoembolization (cTACE) in the treatment of unresectable hepatocellular carcinoma (HCC).

关键词： Irinotecan Gemcitabine transarterial chemoembolization Hepatocellular carcinoma Overall survival

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Prognostic factors for survival after transarterial chemoembolization combined with microwave ablation for hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第46期20卷 17483-17490页

作者： Jia-Yan Ni Hong-Liang Sun Yao-Ting Chen Jiang-Hong Luo Dong Chen Xiong-Ying Jiang Lin-Feng Xu Department of Interventional Radiology Sun Yat-sen Memorial HospitalSun Yat-sen University

AIM: To analyze prognostic factors for survival after transarterial chemoembolization (TACE) combined with microwave ablation (MWA) for hepatocellular carcinoma (HCC).

关键词： Hepatocellular carcinoma transarterial chemoembolization Microwave ablation Survival Prognosis

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Predictive model for acute abdominal pain after transarterial chemoembolization for liver cancer

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World Journal of Gastroenterology 2020年第30期26卷 4442-4452页

作者： Li-Fang Bian Xue-Hong Zhao Bei-Lei Gao Sheng Zhang Guo-Mei Ge Dong-Di Zhan Ting-Ting Ye Yan Zheng Department of Hepatobiliary and Pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Nursing The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Hospital Infection Control The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND transarterial chemoembolization(TACE)is the first-line treatment for patients with unresectable liver cancer;however,TACE is associated with postembolization *** To analyze the risk factors for acute abdominal pain after TACE and establish a predictive model for postembolization *** From January 2018 to September 2018,all patients with liver cancer who underwent TACE at our hospital were *** characteristics;clinical,imaging,and procedural data;and postembolization pain were *** pain was defined as acute moderate-to-severe abdominal pain within 24 h after *** regression and a classification and regression tree were used to develop a predictive *** operating characteristic curve analysis was used to examine the efficacy of the predictive *** We analyzed 522 patients who underwent a total of 582 TACE ***-seven(16.70%)episodes of severe pain occurred.A predictive model built based on the dataset from classification and regression tree analysis identified known invasion of blood vessels as the strongest predictor of subsequent performance,followed by history of TACE,method of TACE,and history of abdominal pain after *** area under the receiver operating characteristic curve was 0.736[95%confidence interval(CI):0.682-0.789],the sensitivity was 73.2%,the specificity was 65.6%,and the negative predictive value was 92.4%.Logistic regression produced similar results by identifying age[odds ratio(OR)=0.971;95%CI:0.951-0.992;P=0.007),history of TACE(OR=0.378;95%CI:0.189-0.757;P=0.007),history of abdominal pain after TACE(OR=6.288;95%CI:2.963-13.342;P<0.001),tumor size(OR=1.978;95%CI:1.175-3.330;P=0.01),multiple tumors(OR=2.164;95%CI:1.243-3.769;P=0.006),invasion of blood vessels(OR=1.756;95%CI:1.045-2.950;P=0.034),and TACE with drug-eluting beads(DEBTACE)(OR=2.05;95%CI:1.260-3.334;P=0.004)as independent predictive factors for postembolization *** Blood vesse

关键词： Liver cancer Predictive model Pain transarterial chemoembolization Postembolization syndrome

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Enhancing global hepatocellular carcinoma management:Bridging Eastern and Western perspectives on dexamethasone and Nacetylcysteine before transarterial chemoembolization

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World Journal of Gastroenterology 2024年第47期30卷 4983-4990页

作者： Thang Viet Luong Nam Van Duc Nguyen Linh Duy Le Hieu Nguyen Hoang Minh Hai Nguyen Ngoc Dang Department of Internal Medicine University of Medicine and PharmacyHue UniversityHue 530000Viet Nam Department of Diagnostic Imaging University of Medicine and PharmacyHue UniversityHue 530000Viet Nam Faculty of Medicine Duy Tan UniversityDa Nang 550000Viet Nam

This article explores the integration of Eastern and Western perspectives on the use of dexamethasone and N-acetylcysteine as premedications in transarterial chemoembolization for hepatocellular carcinoma(HCC).By examining key concerns raised by Western researchers,particularly regarding the different etiologies of liver cirrhosis,and contrasting them with robust clinical data from Asia,this article highlights the necessity for region-specific research and proposes future directions for global HCC management.

关键词： Hepatocellular carcinoma transarterial chemoembolization Dexamethasone N-acetylcysteine East-West perspectives Post-embolization syndrome

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Revisiting the role of pathological analysis in transarterial chemoembolization-treated hepatocellular carcinoma after transplantation

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World Journal of Gastroenterology 2014年第37期20卷 13538-13545页

作者： Francesco Vasuri Deborah Malvi Francesca Rosini Pamela Baldin Michelangelo Fiorentino Alexandro Paccapelo Giorgio Ercolani Antonio Daniele Pinna Rita Golfieri Antonio Maria Morselli-Labate Walter Franco Grigioni Antonia D’Errico-Grigioni "F. Addarii" Institute of Oncology and Transplantation Pathology S.Orsola-Malpighi HospitalBologna University Department of Medical and Surgical Sciences Bologna University Department of Surgery and Transplantation S.Orsola-Malpighi HospitalBologna University Radiology Unit S.Orsola-Malpighi HospitalBologna University

AIM: To define the histopathological features predictive of post-transplant hepatocellular carcinoma (HCC) recurrence after transarterial chemoembolization, applicable for recipient risk stratification.

关键词： chemoembolization Hepatocellular carcinoma Histopathology Orthotopic liver transplantation Cancer recurrence transarterial chemoembolization

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