Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience
Introduction: Trans-arterial chemoembolization (TACE) is a mainstay therapeutic option indicated in early-stage non- resectable hepatocellular carcinoma (HCC) and has been shown to be associated with survival improvements. This study aimed to evaluate the radiological and clinical response of those...
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| Format: | Article |
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Shaikh Zayed Medical Complex, Lahore
2023-07-01
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| Series: | Proceedings |
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| Online Access: | https://proceedings-szmc.org.pk/index.php/szmc/article/view/376 |
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| author | Parvez Ahmed Nasreen Naz Amjad Sattar Nauman al Qamari Imtiaz Ali Faryal Farooq Muhammad Asadullah Rakesh Kumar |
| author_facet | Parvez Ahmed Nasreen Naz Amjad Sattar Nauman al Qamari Imtiaz Ali Faryal Farooq Muhammad Asadullah Rakesh Kumar |
| author_sort | Parvez Ahmed |
| collection | DOAJ |
| description |
Introduction: Trans-arterial chemoembolization (TACE) is a mainstay therapeutic option indicated in early-stage non- resectable hepatocellular carcinoma (HCC) and has been shown to be associated with survival improvements. This study aimed to evaluate the radiological and clinical response of those who underwent TACE.
Aims & Objectives: We aimed to evaluate the radiological and clinical response in patients who underwent Trans- arterial chemoembolization.
Place and Duration of Study: This study was conducted in the Vascular Interventional Radiology Department, Dow Institute of Radiology, Dow University of Health Sciences, Ojha Campus Karachi for a period of 18 months between January 2021 and June 2022.
Material & Methods: HCC patients (n=181) who underwent TACE as their primary treatment at Dow Hospital Ojha Campus Karachi between January 1st, 2021, and June 30th, 2022 were included. Inclusion criteria followed the Barcelona Clinic Liver Cancer (BCLC) and Child-Pugh staging systems. Tumor response was evaluated using “modified Response Evaluation Criteria in Solid Tumors (mRECIST)”, and patients were categorized into complete response (CR) or partial response (PR) groups. The study compared background, clinico-laboratory, and radiological features between these groups, including HCC sizes and CT scan findings before and after TACE. The retrieved data was entered and analyzed using SPSS version.21.
Results: Of the total 118 patients, 51.70% showed CR to the TACE, while PR was noted in 48.30%. Age, sex, viral hepatitis, and co-morbids showed no intergroup differences. However, Child-Pugh stage and BCLC were significantly associated with tumor response. Similarly, laboratory parameters revealed significant mean differences between the two groups (p<0.001), except international normalized ratio and alanine transaminase. Those who had achieved CR had a mean number of tumor less than that of PR. Similarly, tumor size significantly decreased post-TACE (p<0.0001). Moreover, arterial-phase enhancement and portal venous and delayed phases washout tumors before TACE were reported in 76.30%. Over half of the patients had no residual tumor tissue after TACE. Tumors with arterial-phase enhancement and portal venous and delayed phases washout were highly susceptible to TACE.Furthermore, Child-Pugh classA had a greater estimated mean survival than class B (p<0.001).
Conclusion: Over half of the patients showed complete response to the TACE. BCLC staging (B), Child-Pugh (stage A), and small tumors had a favourable effect on the radiological and clinical response in the early-stages of HCC. Tumors with an arterial-phase enhancement and portal venous and delayed phases washout were more susceptible to TACE.
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| first_indexed | 2024-03-11T10:56:09Z |
| format | Article |
| id | doaj.art-4cb89324beeb47c0915b10993e95ea5b |
| institution | Directory Open Access Journal |
| issn | 1815-4905 2518-203X |
| language | English |
| last_indexed | 2024-03-11T10:56:09Z |
| publishDate | 2023-07-01 |
| publisher | Shaikh Zayed Medical Complex, Lahore |
| record_format | Article |
| series | Proceedings |
| spelling | doaj.art-4cb89324beeb47c0915b10993e95ea5b2023-11-13T09:35:35ZengShaikh Zayed Medical Complex, LahoreProceedings1815-49052518-203X2023-07-0137310.47489/szmc.v37i3.376Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute ExperienceParvez Ahmed0Nasreen Naz1Amjad Sattar2Nauman al Qamari3Imtiaz Ali4Faryal Farooq5Muhammad Asadullah6Rakesh Kumar7Department of Radiology, Dow University of Health Sciences, Karachi.Department of Radiology, Dow University of Health Sciences, Karachi.Department of Radiology, Dow University of Health Sciences, Karachi.Department of Radiology, Dow University of Health Sciences, Karachi.Department of Radiology, Liaquat National Hospital, Karachi.Department of Radiology, Dow University of Health Sciences, Karachi.Department of Radiology, Dow University of Health Sciences, Karachi.Department of Radiology, JPMC, Karachi. Introduction: Trans-arterial chemoembolization (TACE) is a mainstay therapeutic option indicated in early-stage non- resectable hepatocellular carcinoma (HCC) and has been shown to be associated with survival improvements. This study aimed to evaluate the radiological and clinical response of those who underwent TACE. Aims & Objectives: We aimed to evaluate the radiological and clinical response in patients who underwent Trans- arterial chemoembolization. Place and Duration of Study: This study was conducted in the Vascular Interventional Radiology Department, Dow Institute of Radiology, Dow University of Health Sciences, Ojha Campus Karachi for a period of 18 months between January 2021 and June 2022. Material & Methods: HCC patients (n=181) who underwent TACE as their primary treatment at Dow Hospital Ojha Campus Karachi between January 1st, 2021, and June 30th, 2022 were included. Inclusion criteria followed the Barcelona Clinic Liver Cancer (BCLC) and Child-Pugh staging systems. Tumor response was evaluated using “modified Response Evaluation Criteria in Solid Tumors (mRECIST)”, and patients were categorized into complete response (CR) or partial response (PR) groups. The study compared background, clinico-laboratory, and radiological features between these groups, including HCC sizes and CT scan findings before and after TACE. The retrieved data was entered and analyzed using SPSS version.21. Results: Of the total 118 patients, 51.70% showed CR to the TACE, while PR was noted in 48.30%. Age, sex, viral hepatitis, and co-morbids showed no intergroup differences. However, Child-Pugh stage and BCLC were significantly associated with tumor response. Similarly, laboratory parameters revealed significant mean differences between the two groups (p<0.001), except international normalized ratio and alanine transaminase. Those who had achieved CR had a mean number of tumor less than that of PR. Similarly, tumor size significantly decreased post-TACE (p<0.0001). Moreover, arterial-phase enhancement and portal venous and delayed phases washout tumors before TACE were reported in 76.30%. Over half of the patients had no residual tumor tissue after TACE. Tumors with arterial-phase enhancement and portal venous and delayed phases washout were highly susceptible to TACE.Furthermore, Child-Pugh classA had a greater estimated mean survival than class B (p<0.001). Conclusion: Over half of the patients showed complete response to the TACE. BCLC staging (B), Child-Pugh (stage A), and small tumors had a favourable effect on the radiological and clinical response in the early-stages of HCC. Tumors with an arterial-phase enhancement and portal venous and delayed phases washout were more susceptible to TACE. https://proceedings-szmc.org.pk/index.php/szmc/article/view/376Hepatocellular carcinomaTrans-Arterial Chemo-embolizationChronic liver diseaseTACEradiological response |
| spellingShingle | Parvez Ahmed Nasreen Naz Amjad Sattar Nauman al Qamari Imtiaz Ali Faryal Farooq Muhammad Asadullah Rakesh Kumar Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience Proceedings Hepatocellular carcinoma Trans-Arterial Chemo-embolization Chronic liver disease TACE radiological response |
| title | Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience |
| title_full | Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience |
| title_fullStr | Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience |
| title_full_unstemmed | Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience |
| title_short | Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience |
| title_sort | trans arterial chemoembolization for the treatment of hepatocellular carcinoma a single tertiary care institute experience |
| topic | Hepatocellular carcinoma Trans-Arterial Chemo-embolization Chronic liver disease TACE radiological response |
| url | https://proceedings-szmc.org.pk/index.php/szmc/article/view/376 |
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