Kim Jihoon, Gwon Dong Il, Kim Yonghun, Kim Gun Ha, Kim Seong Ho, Chu Hee Ho, Kim Jin Hyoung, Shin Ji Hoon, Ko Gi-Young, Yoon Hyun-Ki
Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05502, Republic of Korea.
Ajou University Hospital, College of Medicine, Ajou University, Suwon 16499, Republic of Korea.
Diseases. 2023 Oct 24;11(4):149. doi: 10.3390/diseases11040149.
This study investigates the clinical and pathological outcomes of preoperative balloon-occluded transcatheter arterial chemoembolization (B-TACE) in patients with single hepatocellular carcinoma (HCC). The data are from 25 consecutive patients who underwent sequential treatment of subsegmental B-TACE and hepatic surgery for single HCC. Radiological and pathological evaluation of oily subsegmentectomy, defined as the iodized oil-laden necrotic area that includes the entire HCC and surrounding liver parenchyma, were performed. Subsegmental B-TACE was technically successful in all patients. The major and minor complication rates were 8% and 24%, respectively. On the first follow-up computed tomography (CT), oily subsegmentectomy was observed in 18 (72%) out of 25 patients. Apart from one patient showing a partial response, the remaining 24 (96%) patients showed a complete response. Pathological complete necrosis of the HCC was observed in 18 (72%) out of 25 patients with complete or extensive necrosis of the peritumoral liver parenchyma. The remaining seven patients without peritumoral parenchymal necrosis had extensive necrosis of the HCCs. In conclusion, preoperative B-TACE can be a safe and effective method for the treatment of single HCC and a good bridge treatment for subsequent surgical resection. In addition, oily subsegmentectomy itself on the CT can be a good predictor of pathological complete necrosis of the HCC. The findings obtained from this study would provide a potential role of B-TACE in the treatment strategy for single HCC.
本研究调查了术前球囊闭塞经导管动脉化疗栓塞术（B-TACE）治疗单发肝细胞癌（HCC）患者的临床和病理结果。数据来自25例连续接受亚段B-TACE序贯治疗及单发HCC肝手术的患者。对油剂亚段切除术进行了影像学和病理学评估，油剂亚段切除术定义为包含整个HCC及周围肝实质的碘油填充坏死区域。所有患者的亚段B-TACE技术均成功。主要和次要并发症发生率分别为8%和24%。在首次随访计算机断层扫描（CT）时，25例患者中有18例（72%）观察到油剂亚段切除术。除1例患者显示部分缓解外，其余24例（96%）患者显示完全缓解。25例肿瘤周围肝实质完全或广泛坏死的患者中有18例（72%）观察到HCC的病理完全坏死。其余7例无肿瘤周围实质坏死的患者HCC有广泛坏死。总之，术前B-TACE可以是一种安全有效的单发HCC治疗方法，也是后续手术切除的良好桥梁治疗。此外，CT上的油剂亚段切除术本身可以是HCC病理完全坏死的良好预测指标。本研究获得的结果将为B-TACE在单发HCC治疗策略中的潜在作用提供依据。
