Endovascular treatment of common hepatocellular carcinoma: the experience of one center

Abstract

Objective ‒ to determine the place of transarterial chemoembolization of the liver (TACE) in the modern protocol for treating patients with common hepatocellular carcinoma and by optimizing indications and contraindications to improve the results of complex treatment of these patients.Materials and methods. During the period 2011‒2021 242 TACE procedures were performed on 112 patients with inoperable hepatocellular carcinoma. Conventional lipidol embolization (c-TACE) was performed in 53 patients, procedures with drug eluting beads (DEB-TACE) ‒ in 58. All patients underwent a minimum of 1, a maximum of 5 TACE procedures. The decision to re-TACE was made individually, according the prevalence of the lesion (for bilobar lesions performed at least 2 unilobar TACE) and the tumor’s response to the intervention. Results. TACE results were evaluated according to mRECIST criteria: complete tumor response (CR) was noted in 3 (2.7 %) cases, partial (PR) ‒ in 68 (60.7 %) cases, process stabilization (SD) ‒ in 29 (25.9 %), progression (PD) ‒ 12 (10.7 %) cases. According by the obtained results, convincing data for the superiority of any of the applied TACE methods were not found. Repeated TACE courses increase the overall effectiveness of the treatment. Conclusions. The use of TACE in patients with inoperable hepatocellular carcinoma allows with minimal invasiveness to reduce or stabilize tumor growth in 89.3 % of cases. Repeated performance of the procedure allows to increase the treatment efficiency by 21.2 %.