Aims and objectives
A small number of patients with hepatocellular carcinoma (HCC) are candidates for surgical resection with curative intent,
therefore,
the vast majority can benefit from minimally invasive image-guided locoregional therapies [1].
The Quality Improvement Guidelines (QIG) of the Society of Interventional Radiology (SIR) recommend various quality standards for these therapies [2].
We aimed to report our experience with these therapies,
particularly outcomes related to treatment efficacy and complication rates.
Methods and materials
Retrospective descriptive study of patients treated with trans-arterial chemoembolization (TACE) and/or percutaneous ablation of HCC from January 2015 to June 2018.
Inclusion criteria
Patients who were treated with TACE and/or percutaneous ablation in Clinica Alemana in Santiago,
Chile,
between January 2015 and June 2018.
BCLC stage (Barcelona Clinic Liver Cancer Staging System) A or B.
Liver focal lesions classified as LIRADS (Liver Imaging Reporting and Data System) 4 or 5.
Exclusion criteria
Patients with missing data in the clinical history
Patients without follow-up with diagnostic...
Results
A total of 71 patients were included.
Mean age was 67 years.
135 procedures were performed with an average of 1.9 procedures per patient (SD 1.1).
Nonalcoholic steatohepatitis was the most common cause of liver disease.
The most frequent treatment goal was palliation,
followed by bridge to liver transplantation (Fig.
1 and 2).
A median of 90 days between pre-treatment imaging and procedure (IQR: 91) and a median of 34 days between procedure and post-treatment imaging (IQR: 30) was observed.
In per-lesion analysis,
there was...
Conclusion
We present the characteristics and results of the patients treated for HCC throughTACE of percutaneous ablation in our institution.
In our population,
the majority of patients were men with a mean age of 67 years,
similar to the demographic characteristics found in other studies [3].
The most frequent cause of cirrhosis in our patients was nonalcoholic steatohepatitis,
which differs from the series by Zheng et al.
[4] and by Morales [5],
which had C hepatitis infection as the most frequent cause.
The SIR establishes a...
References
1.-Schutte K,
Bornschein J,
Malfertheiner P.
Hepatocellular carcinoma— epidemiological trends and risk factors.
Dig Dis 2009; 27:80–92.
2.- Gaba RC,
Lokken RP,
Hickey RM,
Lipnik AJ,
Lewandowski RJ,
Salem R,
Brown DB,
Walker TG,
Silberzweig JE,
Baerlocher MO,
Echenique AM,
Midia M,
Mitchell JW,
Padia SA,
Ganguli S,
Ward TJ,
Weinstein JL,
Nikolic B,
Dariushnia SR; Society of Interventional Radiology Standards of Practice Committee.
Quality Improvement Guidelines for Transarterial Chemoembolization and Embolization of Hepatic Malignancy.J Vasc Interv Radiol.
2017;28:1210-1223.e3.
3.- Ding J,
Jing X,
Wang...