The Safety and Effectiveness of Hepatic Transarterial Embolic Locoregional Therapy in Patients with Contraindications to Hepatectomy after Portal Vein Embolization |
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| Affiliation: | 1. Department of Radiology, Hôpital Beaujon, AP-HP.Nord, Paris, France;2. Liver Cancer Unit, Hôpital Beaujon, AP-HP.Nord, Paris, France;3. Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, AP-HP.Nord, Paris, France;4. Department of Nuclear Medicine, Hôpital Beaujon, AP-HP.Nord, Paris, France;5. Université Paris Cité, INSERM U1149 “Centre de Recherche sur l’Inflammation,” CRI, Paris, France;1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California San Francisco, San Francisco, California;2. Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;3. Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;4. Division of Gastroenterology, Hepatology, Department of Medicine, and Nutrition, University of Florida Health, Gainesville, Florida;5. Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana;6. Section of Gastroenterology, Hepatology & Nutrition, Department of Medicine, The University of Chicago Pritzker School of Medicine, Chicago, Illinois;7. Department for Organ and Cell Transplantation, The Scripps Clinic, La Jolla, California;8. Department of Medicine, Center for Liver Disease and Transplantation, Columbia University College of Physicians & Surgeons, New York, New York;9. Department of Internal Medicine, Banner University Medical Center, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona;10. Division of Vascular Interventional Radiology, Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois;11. Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California;1. Boston University Chobanian & Avedisian School of Medicine, Boston, MA;2. Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215;1. Division of Plastic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;2. Section of Interventional Radiology, Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;3. Center for Lymphatic Imaging and Interventions, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;1. Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts;2. Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Health, Detroit, Michigan;3. Department of Anesthesiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts;1. Department of Radiology, The Jikei University Hospital, Tokyo, Japan;2. Department of Pathology, The Jikei University Hospital, Tokyo, Japan |
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| Abstract: | The safety and effectiveness of hepatic transarterial embolic locoregional therapy (LRT) was assessed, including transarterial chemoembolization (TACE) and transarterial radioembolization (TARE), in patients who underwent portal vein embolization (PVE) before major hepatectomy in whom surgery was then contraindicated. Adverse events (AEs) were graded according to the Society of Interventional Radiology classification of AEs. Tumor response was assessed based on the Response Evaluation Criteria In Solid Tumors 1.1. Overall survival (OS) and progression-free survival (PFS) were estimated. Fifteen patients underwent 37 transarterial LRTs (25 TACEs, 11 TAREs, and 1 bland embolization), most (73%) with hepatocellular carcinoma. Eleven AEs occurred in 7 patients, including 2 Grade 3/5 (severe) and 2 Grade 4/5 (life-threatening) events. The best response was partial response in 4 (27%) and stable disease in 10 (66%) patients. The median OS and PFS were 42 (95% CI, 35–49 months) and 33 months (95% CI, 24–42 months), respectively. In conclusion, hepatic transarterial LRT can be considered as a therapeutic option in patients with contraindicated liver surgery after PVE. |
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