Table 12.
Transcatheter arterial chemoembolization
|
Hepatocellular carcinoma n (%) |
Intrahepatic cholangiocarcinoma n (%) |
Combined hepatocellular cholangiocarcinoma n (%) |
|
|---|---|---|---|
| Transarterial therapy | n = 16 920 | n = 76 | n = 115 |
| Not performed | 8586 (50.7) | 697 (91.6) | 74 (64.3) |
| Performed | 8334 (49.3) | 64 (8.4) | 41 (35.7) |
| Transcatheter arterial chemoembolization | n = 8283 | n = 63 | n = 41 |
| Not performed | 729 (8.8) | 24 (38.1) | 11 (26.8) |
| Performed | 7554 (91.2) | 39 (61.9) | 30 (73.2) |
| Therapy through implanted catheter system | n = 7102 | n = 56 | n = 41 |
| Not performed | 6488 (91.4) | 42 (75.0) | 32 (78.0) |
| Performed | 614 (8.6) | 14 (25.0) | 9 (22.0) |
| Embolic agent | n = 7012 | n = 33 | n = 30 |
| Lipiodol alone | 1125 (16.0) | 8 (24.2) | 10 (33.3) |
| Gelatin sponge alone | 157 (2.2) | 1 (3.0) | 2 (6.7) |
| Lipiodol + gelatin sponge | 5518 (78.7) | 22 (66.7) | 17 (56.7) |
| Other | 212 (3.0) | 2 (6.1) | 1 (3.3) |
| Lipiodol dose | n = 5250 | n = 18 | n = 20 |
| Not used | 2 (0.0) | 0 (0.0) | 0 (0.0) |
| 0.1–1.0 | 440 (8.4) | 0 (0.0) | 1 (5.0) |
| 1.1–3.0 | 2002 (38.1) | 5 (27.8) | 4 (20.0) |
| 3.1–5.0 | 1439 (27.4) | 7 (38.9) | 10 (50.0) |
| 5.1–7.0 | 559 (10.6) | 3 (16.7) | 2 (10.0) |
| 7.1–10.0 | 662 (12.6) | 3 (16.7) | 3 (15.0) |
| >10 | 146 (2.8) | 0 (0.0) | 0 (0.0) |
| Combination with chemotherapy agents | n = 7804 | n = 38 | n = 30 |
| Doxorubicin | 399 | 2 | 0 |
| Epirubicin | 4281 | 16 | 19 |
| Mitomycin | 1008 | 4 | 3 |
| Cisplatin | 1416 | 10 | 6 |
| SMANCS | 203 | 3 | 1 |
| Miriplatin | 131 | 0 | 0 |
| 5FU | 97 | 1 | 1 |
| Interferon | 17 | 1 | 0 |
| Other | 252 | 1 | 0 |
| Percentages not calculated as multiple choices were allowed | |||
| Area of embolization | n = 6385 | n = 33 | n = 24 |
| <1 segment | 2339 (36.6) | 10 (30.3) | 3 (12.5) |
| ≥1 segment to <1 lobe | 2574 (40.3) | 12 (36.4) | 10 (41.7) |
| ≥1 lobe to < entire liver | 1058 (16.6) | 9 (27.3) | 8 (33.3) |
| Entire liver | 414 (6.5) | 2 (6.1) | 3 (12.5) |
| Complications | n = 241 | n = 2 | n = 0 |
| Acute cholecystitis | 26 | 1 | 0 |
| Biloma | 10 | 0 | 0 |
| Hepatic abscess | 27 | 0 | 0 |
| Hepatic infarction | 11 | 0 | 0 |
| Liver failure | 48 | 0 | 0 |
| Tumor rupture | 9 | 0 | 0 |
| Gastrointestinal hemorrhage | 10 | 0 | 0 |
| Pulmonary infarction | 0 | 0 | 0 |
| Spinal cord injury | 0 | 0 | 0 |
| Other | 100 | 1 | 0 |
| Percentages not calculated as multiple choices were allowed | |||
| Direct response assessment | n = 5602 | n = 28 | n = 22 |
| TE4a | 1134 (20.2) | 5 (17.9) | 1 (4.5) |
| TE4b | 1494 (26.7) | 3 (10.7) | 4 (18.2) |
| TE3 | 1459 (26.0) | 9 (32.1) | 6 (27.3) |
| TE2 | 1053 (18.8) | 6 (21.4 | 7 (31.8) |
| TE1 | 325 (5.8) | 3 (10.7) | 2 (9.1) |
| Overall response at 3 months | n = 5128 | n = 23 | n = 19 |
| CR | 2100 (41.0) | 7 (30.4) | 3 (15.8) |
| PR | 1118 (21.8) | 5 (21.7) | 4 (21.1) |
| SD | 803 (15.7) | 5 (21.7) | 6 (31.6) |
| PD | 1107 (21.6) | 6 (26.1) | 6 (31.6) |
| Overall response at 6 months | n = 4505 | n = 21 | n = 16 |
| CR | 1806 (40.1) | 5 (23.8) | 2 (12.5) |
| PR | 781 (17.3) | 5 (23.8) | 3 (18.8) |
| SD | 545 (12.1) | 2 (9.5) | 3 (18.8) |
| PD | 1373 (30.5) | 9 (42.9) | 8 (50.0) |
For all parameters, n is the total number of patients, excluding those in the “unknown” category, and (%) is the percentage of n.
5FU, fluorouracil; CR, complete response; PD, progressive disease; PR, partial response; SD, stable disease; SMANCS, styrene maleic acid neocarzinostatin; TE1, treatment effect in target lesion (progressive disease); TE2, treatment effect in target lesion (partial response); TE3, treatment effect in target lesion (partial response); TE4a; treatment effect in target lesion (complete response with ablative margin); TE4b, treatment effect in target lesion (complete response without ablative margin).