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Portal blood supply to locally progressed hepatocellular carcinoma after transcatheter arterial chemoembolization: Observation on CT during arterial portography.
- Source :
-
Hepatology research : the official journal of the Japan Society of Hepatology [Hepatol Res] 2011 Sep; Vol. 41 (9), pp. 853-66. Date of Electronic Publication: 2011 Jun 23. - Publication Year :
- 2011
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Abstract
- Aim: To analyze the clinical features of locally progressed hepatocellular carcinoma (HCC) supplied by portal blood (PB) after transcatheter arterial chemoembolization (TACE).<br />Methods: This cohort included 12 tumors (mean diameter ± SD, 1.8 ± 0.8 cm) in 10 patients. PB supply to tumors was judged by CT during arterial portography (CTAP). Imaging data and the clinical course were retrospectively evaluated.<br />Results: Six tumors initially had a small tumor portion supplied by PB. In four tumors, TACE was incomplete because of technical problems. PB supply to recurrent tumors was demonstrated 7.3 ± 3.7 months after TACE. On follow-up arteriography, all embolized branches were occluded or severely attenuated. Four tumors showing a partial stain were treated by additional TACE (n = 3) or TACE plus radiofrequency (RF) ablation (n = 1), one without staining was treated by RF ablation, and seven were followed-up. All tumors progressed except for one treated by RF ablation. On serial CTAP images, relatively large-diameter portal veins directly entered 11 tumors (91.7%) and connected with intratumoral vessels in nine (75%). During follow-up, partial arterial supply was demonstrated in two tumors and additional TACE was performed. Nine patients died after 31.4 ± 16.2 months due to tumor progression (n = 8), or hepatic failure (n = 1). One patient has survived for 53 months despite multiple tumors.<br />Conclusions: PB supply to locally progressed tumor after TACE became apparent on CTAP. Arterial damage by TACE, incomplete TACE, and preexisting tumor tissues supplied by PB may be the main causes.<br /> (© 2011 The Japan Society of Hepatology.)
Details
- Language :
- English
- ISSN :
- 1872-034X
- Volume :
- 41
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Hepatology research : the official journal of the Japan Society of Hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 21699636
- Full Text :
- https://doi.org/10.1111/j.1872-034X.2011.00836.x