Factors affecting tumor response to transarterial chemoembolization (TACE) therapy in patient with hepatocellular carcinoma (HCC)

https://doi.org/10.19106/JMedSci005202202006

Alia Amalia(1*), Nikmatia Latief(2), Bachtiar Murtala(3), Andi Alfian Zainuddin(4), Nu’man AS Daud(5)

(1) Department of Radiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
(2) Department of Radiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
(3) Department of Radiology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
(4) Department of Public Health and Family Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
(5) Department of Internal Medicine, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia
(*) Corresponding Author

Abstract


Hepatocellular carcinoma (HCC) is a major problem of global health.Transarterial chemoembolization (TACE) is the treatment of choice for unresectable HCC. The TACE is routinely conducted in major hospitals in Indonesia, however it rarely published.The use of modified response in evaluation criteria in solid tumors (mRECIST) was introduced as an accurate method of measuring tumor response in HCC. This study aimedto investigate the factorsaffecting tumor response to TACE therapy in HCC patients by using mRECIST. It was a retrospective cohort study conducted on 30 patients who successfully underwent the first TACE procedure in the Department of Radiology, Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia from January 2016 to August 2019. The multiphase abdominal computed tomography before and after as well as laboratory examination results before TACE were collected and analyzed. Chi-Square and Spearman-tests were used for the statistical analysis. A significant relationship between tumor location (p=0.016), number of tumor (p=0.001) and Child-Pugh score with tumor response to TACE therapy (p = 0.016) was observed. Solitary tumors tend to have a better therapeutic response, meanwhile, tumors located in the left lobe of patients with Child-Pugh B scores showed a decreased tumor response. Furthermore, no a significant relationship between age (p=0.920), sex (p=0.303), tumor size> 5 cm (p=0.082) and alpha-fetoprotein (AFP) levels (p=0.414) with tumor response was observed. In conclusion, TACE is preferably therapy for multinodular and unresectable HCC. Tumor response after TACE can be well assessed using mRECIST. The factorsaffecting tumor response to TACE therapy arenumber of tumor, location, and Child-Pugh score


Keywords


tumor respons; ransarterial chemoembolization; hepatocellular carcinoma; mRECIST; solid tumor;

Full Text:

PDF


References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin2018; 68:394-424. https://doi.org/10.3322/caac.21492
  2. Park YN, Kim MJ. Hepatocarcinogenesis: imaging-pathologic correlation. Abdom Imaging 2011; 36(3):232–43. https://doi.org/10.1007/s00261-011-9688-y
  3. Brody RI, Theise ND. An inflammatory proposal for hepatocarcinogenesis. Hepatology 2012; 56(1):382–4. https://doi.org/10.1002/hep.25759
  4. Blumgart LH, Belghiti J. Surgery of the liver, biliary tract, and pancreas. 3rd edition. Philadelphia: Saunders Elsevier, 2007. 3–30.
  5. Llovet JM, Ducreux M, Lencioni R, Di Bisceglie AM, Galle PR, Dufour JF, et al. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer 2012; 48(5): 599-641. https://doi.org/10.1016/j.ejca.2011.12.021
  6. Bruix J, Sherman M. Practice guidelines committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology 2011; 53(3): 1020-52. https://doi.org/10.1002/hep.24199
  7. Miki I, Murata S, Uchiyama F, Yasui D, Ueda T, Sugihara F, et al. Evaluation of the relationship between hepatocellular carcinoma location and transarterial chemoembolization efficacy. World J Gastroenterol 2017; 23(35):6437-47. https://doi.org/10.3748/wjg.v23.i35.6437
  8. Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis 2010; 30(1):52–60. https://doi.org/10.1055/s-0030-1247132
  9. Vesselle G, Silvain C, Leleu CQ, Boucebci S, Velasco S, Ingrand P, et al. Predictive factors for complete response of chemoembolization with drug-eluting beads (DEB-TACE) for hepatocellular carcinoma. Eur Radiol 2015; 10:1-9. https://doi.org/10.1007/s00330-015-3982-y
  10. Yang Hsu C, Hong Liu P, Lee YH, Hsia CY, Huang YH, Lin HC, et al. Using serum a-fetoprotein for prognostic prediction in patients with hepatocellular carcinoma: what is the most optimal cutoff? Plos One 2015; 3:1-12. https://dx.doi.org/10.1371/journal.pone.0118825
  11. Nishikawa H, Kita R, Kimura T, Ohara Y, Takeda H, Sakamoto A, et al. Transcatheter arterial chemoembolization for intermediate-stage hepatocellular carcinoma: clinical outcome and safety in elderly patients. JCancer 2014; 5(7):590-7. https://doi.org/10.7150/jca.9413
  12. Bryant MK, Dorn DP, Zarzour J, Smith JK, Redden DT, Saddekni S, et al. Computed tomography predictors of hepatocellular carcinoma tumour necrosis after chemoembolization. HPB 2014; 16(4):327–35. https://doi.org/10.1111/hpb.12149
  13. Miyayama S, Yamashiro M, Hattori Y, Orito N, Matsui K, Tsuji K, et al. Angiographic evaluation of feeding arteries of hepatocellular carcinoma in the caudate lobe of the liver. Cardiovasc Intervent Radiol 2011; 34(6):1244–53. https://doi.org/10.1007/s00270-010-0036-3
  14. Wu X, Chen R, Zheng W, Hu H. Comprehensive analysis of factors affecting clinical response and short-term survival to drug-eluting bead transarterial chemoembolization for treatment in patients with liver cancer. TechnolCancer ResTreat 2018; 17:1-15. https://doi.org/10.1177/1533033818759878
  15. Farinati F, Marino D, De Giorgio M, Baldan A, Cantarini M, Cursaro C, et al. Diagnostic and prognostic role of alpha-fetoprotein in hepatocellular carcinoma: both or neither? Am J Gastroentero 2006; 101:524-32. https://doi.org/10.1111/j.1572-0241.2006.00443.x



DOI: https://doi.org/10.19106/JMedSci005202202006

Article Metrics

Abstract views : 1965 | views : 2210


Bookmark and Share


Copyright (c) 2020 Alia Amalia, Nikmatia Latief, Bachtiar Murtala, Andi Alfian Zainuddin, Nu’man AS Daud

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.