Conventional transcatheter arterial chemoembolization with gelatin spheres for hepatocellular carcinoma: comparison with nonspherical gelatin sponge particles.

Abstract

Objective: To compare the therapeutic effect, adverse events, and hepatic artery injury (HAI) between gelatin spheres (GS) and nonspherical gelatin sponge particles (GP) in conventional transcatheter arterial chemoembolization (C-TACE).

Materials and methods: A total of 368 consecutive patients with hepatocellular carcinoma (HCC) who underwent C-TACE between September 2019 and May 2021 were included in this single center retrospective study. Adverse events, radiologic tumor response, local tumor recurrence, and HAI were evaluated.

Results: Subsegmental C-TACE was performed using biodegradable GS in 165 patients and nonspherical biodegradable GP in 203 patients. No significant differences in patient background existed between the groups, and there was no significant difference in adverse event rate (p = 0.231). The CR and overall tumor response in the GS and GP groups were 73.3% vs 70.9%, and 99.4% vs 98.5%, respectively, with no significant between-group differences (p = 0.642 and p = 0.631). No significant difference in cumulative local tumor recurrence rate existed between the groups (p = 0.558). HAI was observed in 16% (20 of 125 patients) in the GS group and 37.4% (49 of 131 patients) in the GP group. The incidence of HAI was significantly higher in the GP group than in the GS group (p < 0.001). In multiple logistic regression analysis, risk factors for HAI were index tumor size ≥ 3 cm (p = 0.001) and use of GP (p < 0.001).

Conclusion: C-TACE with GS resulted in the same therapeutic and adverse effects as C-TACE with nonspherical GP while causing significantly less HAI.

Key points: Question Comparisons between GS and nonspherical GP are lacking, and the potential advantages of GS over nonspherical GP are not well studied. Findings HAI incidence was higher in the GP than the GS group, and risk factors of HAI were index tumor size ≥ 3 cm and GP use. Clinical relevance C-TACE with GS resulted in the same therapeutic and adverse effects as C-TACE with nonspherical GP while causing significantly less HAI.