Drug-eluting bead transarterial chemoembolization as neoadjuvant therapy pre-liver transplantation for advanced-stage hepatocellular carcinoma

被引:0
|
作者
Ye, Zhao-Dan [1 ]
Zhuang, Li [2 ]
Song, Meng-Chen [1 ]
Yang, Zhe [2 ]
Zhang, Wu [2 ]
Zhang, Jing-Feng [3 ]
Cao, Guo-Hong [1 ]
机构
[1] Zhejiang Shuren Univ, Dept Radiol, Shulan Hangzhou Hosp, Shulan Int Med Coll, 848 Dongxin Rd, Hangzhou 310022, Zhejiang, Peoples R China
[2] Zhejiang Shuren Univ, Shulan Int Med Coll, Shulan Hangzhou Hosp, Dept Hepatobiliary & Pancreat Surg, Hangzhou 310000, Zhejiang, Peoples R China
[3] Univ Chinese Acad Sci, Hwa Mei Hosp, Diagnost & Therapeut Ctr Difficult Dis, Ningbo 315010, Zhejiang, Peoples R China
关键词
Hepatocellular carcinoma; Liver transplantation; Portal vein tumor thrombus; Drug-eluting bead transarterial chemoembolization; Neoadjuvant treatment; VEIN TUMOR THROMBOSIS; SORAFENIB; EFFICACY; INVASION;
D O I
10.4251/wjgo.v16.i6.2476
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND The objectives of this study were to assess the safety and efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) as neoadjuvant therapy before liver transplantation (LT) for advanced-stage hepatocellular carcinoma (HCC) and to analyze the prognostic factors. AIM To determine whether DEB-TACE before LT is superior to LT for advanced-stage HCC. METHODS A total of 99 individuals diagnosed with advanced HCC were studied retrospectively. The participants were categorized into the following two groups based on whether they had received DEB-TACE before LT: DEB-TACE group (n = 45) and control group (n = 54). The participants were further divided into two subgroups based on the presence or absence of segmental portal vein tumor thrombus (PVTT). The DEB-TACE group consisted of two subgroups: Group A (n = 31) without PVTT and group B (n = 14) with PVTT. The control group also had two subgroups: Group C (n = 37) without PVTT and group D (n = 17) with PVTT. Data on patient demographics, disease characteristics, therapy response, and adverse events (AEs) were collected. The overall survival (OS) and recurrence-free survival (RFS) rates were assessed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were conducted to determine the parameters that were independently related to OS and RFS. RESULTS The DEB-TACE group exhibited an overall response rate of 86.6%. Following therapy, there was a significant decrease in the median alpha-fetoprotein (AFP) level (275.1 ng/mL vs 41.7 ng/mL, P < 0.001). The main AE was post-embolization syndrome. The 2-year rates of RFS and OS were significantly higher in the DEB-TACE group than in the control group (68.9% vs 38.9%, P = 0.003; 86.7% vs 63.0%, P = 0.008). Within the subgroups, group A had higher 2-year rates of RFS and OS compared to group C (71.0% vs 45.9%, P = 0.038; 83.8% vs 62.2%, P = 0.047). The 2-year RFS rate of group B was markedly superior to that of group D (64.3% vs 23.5%, P = 0.002). Results from multivariate analyses showed that pre-LT DEB-TACE [hazard ratio (HR) = 2.73, 95% confidence interval (CI): 1.44-5.14, P = 0.04], overall target tumor diameter <= 7 cm (HR = 1.98, 95%CI: 1.05-3.75, P = 0.035), and AFP level <= 400 ng/mL (HR = 2.34; 95%CI: 1.30-4.19, P = 0.009) were significant risk factors for RFS. Additionally, pre-LT DEB-TACE (HR = 3.15, 95%CI: 1.43-6.96, P = 0.004) was identified as a significant risk factor for OS. CONCLUSION DEB-TACE is a safe and efficient therapy for advanced-stage HCC and also enhances patient survival after LT.
引用
收藏
页码:2476 / 2486
页数:12
相关论文
共 50 条
  • [1] Drug-Eluting Bead Transarterial Chemoembolization as Bridge Therapy for Hepatocellular Carcinoma Before Living-Donor Liver Transplantation
    Yu, C. -Y.
    Ou, H. -Y.
    Weng, C. -C.
    Huang, T. -L.
    Chen, T. -Y.
    Leung-Chit, L.
    Hsu, H. -W.
    Chen, C-L
    Cheng, Y-F
    TRANSPLANTATION PROCEEDINGS, 2016, 48 (04) : 1045 - 1048
  • [2] Conventional transarterial chemoembolization versus drug-eluting bead transarterial chemoembolization for the treatment of hepatocellular carcinoma
    Kloeckner, Roman
    Weinmann, Arndt
    Prinz, Friederike
    dos Santos, Daniel Pinto
    Ruckes, Christian
    Dueber, Christoph
    Pitton, Michael Bernhard
    BMC CANCER, 2015, 15
  • [3] Conventional transarterial chemoembolization versus drug-eluting bead transarterial chemoembolization for the treatment of hepatocellular carcinoma
    Roman Kloeckner
    Arndt Weinmann
    Friederike Prinz
    Daniel Pinto dos Santos
    Christian Ruckes
    Christoph Dueber
    Michael Bernhard Pitton
    BMC Cancer, 15
  • [4] Safety and Effectiveness of Chemoembolization with Drug-Eluting Beads for Advanced-Stage Hepatocellular Carcinoma
    Kalva, Sanjeeva P.
    Pectasides, Melina
    Liu, Raymond
    Rachamreddy, Niranjan
    Surakanti, Shravani
    Yeddula, Kalpana
    Ganguli, Suvranu
    Wicky, Stephan
    Blaszkowsky, Lawrence S.
    Zhu, Andrew X.
    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 2014, 37 (02) : 381 - 387
  • [5] Safety and Effectiveness of Chemoembolization with Drug-Eluting Beads for Advanced-Stage Hepatocellular Carcinoma
    Sanjeeva P. Kalva
    Melina Pectasides
    Raymond Liu
    Niranjan Rachamreddy
    Shravani Surakanti
    Kalpana Yeddula
    Suvranu Ganguli
    Stephan Wicky
    Lawrence S. Blaszkowsky
    Andrew X. Zhu
    CardioVascular and Interventional Radiology, 2014, 37 : 381 - 387
  • [6] Safety and Efficacy of Doxorubicin Drug-eluting Bead Transarterial Chemoembolization in Patients with Advanced Hepatocellular Carcinoma
    Prajapati, Hasmukh J.
    Dhanasekaran, Renumathy
    El-Rayes, Bassel F.
    Kauh, John S.
    Maithel, Shishir K.
    Chen, Zhengjia
    Kim, Hyun S.
    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2013, 24 (03) : 307 - 315
  • [7] Sorafenib plus drug-eluting bead transarterial chemoembolization for early intrahepatic stage-progressed advanced hepatocellular carcinoma refractory to conventional transarterial chemoembolization
    Fan, Wenzhe
    Zhu, Bowen
    Zheng, Xinlin
    Yue, Shufan
    Lu, Mingjian
    Fan, Huishuang
    Qiao, Liangliang
    Li, Fuliang
    Yuan, Guosheng
    Wu, Yanqin
    Zou, Xinhua
    Wang, Hongyu
    Xue, Miao
    Li, Jiaping
    JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, 2023, 149 (05) : 1873 - 1882
  • [8] Sorafenib plus drug-eluting bead transarterial chemoembolization for early intrahepatic stage-progressed advanced hepatocellular carcinoma refractory to conventional transarterial chemoembolization
    Wenzhe Fan
    Bowen Zhu
    Xinlin Zheng
    Shufan Yue
    Mingjian Lu
    Huishuang Fan
    Liangliang Qiao
    Fuliang Li
    Guosheng Yuan
    Yanqin Wu
    Xinhua Zou
    Hongyu Wang
    Miao Xue
    Jiaping Li
    Journal of Cancer Research and Clinical Oncology, 2023, 149 : 1873 - 1882
  • [9] Combination therapy of sorafenib and drug-eluting bead transarterial chemoembolization for advanced hepatocellular carcinoma with and without hepatic arteriovenous shunt
    Chen, Pin-Ko
    Chiu, Sung-Hua
    Tsai, Ming-Ting
    Chang, Kai-Hsiang
    Chang, Wei-Chou
    Lin, Hsuan-Hwai
    Lo, Cheng-Hsiang
    Huang, Guo-Shu
    Chang, Ping-Ying
    JOURNAL OF THE CHINESE MEDICAL ASSOCIATION, 2022, 85 (04) : 491 - 499
  • [10] Does neoadjuvant doxorubicin drug-eluting bead transarterial chemoembolization improve survival in patients undergoing liver transplant for hepatocellular carcinoma?
    Dorcaratto, Dimitri
    Udupa, Venkatesha
    Hogan, Niamh M.
    Brophy, David P.
    McCann, Jeffrey W.
    Maguire, Donal
    Geoghegan, Justin
    Cantwell, Colin P.
    Hoti, Emir
    DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY, 2017, 23 (06) : 441 - 447