Hepatocellular Carcinoma Responding to Superselective Transarterial Chemoembolization: An Issue of Nodule Dimension?

被引：103

作者：

Golfieri, Rita ^{[1
]}

Renzulli, Matteo ^{[1
]}

Mosconi, Cristina ^{[1
]}

Forlani, Ludovica ^{[1
]}

Giampalma, Emanuela ^{[1
]}

Piscaglia, Fabio ^{[2
]}

Trevisani, Franco ^{[3
]}

Bolondi, Luigi ^{[2
]}

机构：

[1] Univ Bologna, Radiol Unit, Dept Digest Dis & Internal Med, Alma Mater Studiorum St Orsola Malpighi Hosp, I-40138 Bologna, Italy

[2] Univ Bologna, Div Internal Med, Dept Digest Dis & Internal Med, Alma Mater Studiorum St Orsola Malpighi Hosp, I-40138 Bologna, Italy

[3] Univ Bologna, Div Med Semeiot, Dept Digest Dis & Internal Med, Alma Mater Studiorum St Orsola Malpighi Hosp, I-40138 Bologna, Italy

来源：

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY | 2013年 / 24卷 / 04期

关键词：

TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION; TUMOR RESPONSE; LOCAL RECURRENCE; END-POINTS; SURVIVAL; EMBOLIZATION; ANGIOGRAPHY; EFFICACY; CRITERIA; OUTCOMES;

D O I：

10.1016/j.jvir.2012.12.013

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

100231 [临床病理学]; 100902 [航空航天医学];

摘要：

Purpose: To evaluate the per-nodule efficacy of superselective transarterial chemoembolization of hepatocellular carcinomas (HCCs). Materials and Methods: From 2006-2009, 271 cirrhotic patients with 635 nodules underwent a first superselective transarterial Chemoembolization, repeated on demand after local recurrences (LR) or partial responses Complete response (CR), time to nodule progression,(TTnP), and local recurrence rate (LRR), according to three size classes (<= 2 cm, 2.1-5 cm, and > 5 cm) were evaluated. Results: After the first superselective transarterial chemoembolization, the CR Was 64%, sustained over time in 77%, higher in small (68%) and intermediate-size (64%) nodules than in large nodules (25%; P The LRR was 23% 20% in small; 27% in intermediate, and 67% in large HCCs.(P < .05). The median TTnP of large HCCs Was 4 months versus 7-9 months for Small-arid intermediate HCCs. The second superselective transarterial chemoembolization achieved a higher CR (63% in LR, 52% in PR) than the third superselective transarterial chemoembolization (32%). Median TTnP after the second superselective transarterial chemoembolization for LR and PR (8 months and 6 months) was longer than after the third superselective transarterial chemoembolization (3.5 months). Nodules <= 5 cm had a. CR after the first superselective transarterial chemoembolization (66%) and the second superselective transarterial chemoembolization for LR (64%) or PR (55%) higher than after the third superselective transarterial chemoembolization (40%); nodules > 5 cm had a CR of 25% after the first superselective transarterial chemoembolization, LR of 50% and PR of 25%, and after the second and third superselective transarterial chemoembolizations, PR of 0%, Conclusions: Effectiveness of superselective transarterial chemoembolization has a clear cutoff above and below 5-cm nodules, with better results in smaller nodules. In HCCs <= 5 cm, the efficacy Of the first and second superselective transarterial chemoembolizations performed for LR was higher than the second superselective transarterial chemoembolization for PR and the third superselective transarterial chemoembolization. For HCCs > 5 cm, retreatment of PR is of little value, and the third cycle is ineffective.

引用

页码：509 / 517

页数：9

共 40 条

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Hepatocellular Carcinoma: CT for Tumor Response after Transarterial Chemoembolization in Patients Exceeding Milan Criteria-Selection Parameter for Liver Transplantation [J].