Faculty Collaboration Database

Safety and efficacy of transarterial chemoembolization in patients with transjugular intrahepatic portosystemic shunts. HPB (Oxford) 2015 Aug;17(8):707-12

Date

07/15/2015

Pubmed ID

26172137

Pubmed Central ID

PMC4527856

DOI

10.1111/hpb.12433

Scopus ID

2-s2.0-84937001665 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

BACKGROUND: Transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) is an important option as the majority of patients present with advanced disease. Data regarding treatment outcomes in patients who have undergone transjugular intrahepatic portosystemic shunts (TIPS) are limited. The present study seeks to evaluate the safety and efficacy of TACE in HCC patients with a TIPS.

METHODS: A retrospective review identifying patients with HCC and concomitant TIPS who were treated with TACE was performed.

RESULTS: From 1999 to 2014, 16 patients with HCC underwent a total of 27 TACE procedures; eight patients required multiple treatments. The median patient age at the time of the initial TACE was 60.5 years [interquartile range (IQR) : 52.5-67.5] with the majority being male (n = 12, 75%) and Childs-Pugh Class B (n = 12, 75%). At 6 weeks after TACE, 56.3% of patients achieved an objective response rate (complete and partial response) by mRECIST criteria. Clavien Grade 3 or higher complications occurred in 11.1% of TACE procedures. There were no peri-procedural deaths. The median progression-free (PFS) and overall survival (OS) were 9 and 22 months, respectively, when censored for liver transplantation (median follow-up: 11.5 months).

CONCLUSION: TACE is an effective treatment strategy for HCC in TIPS patients; albeit may be associated with higher complication rates.

Author List

Miura JT, Rilling WS, White SB, Hieb RA, Tutton SM, Patel PJ, Gamblin TC, Hohenwalter EJ

Authors

Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin
Robert A. Hieb MD, RVT, FSIR Professor in the Radiology department at Medical College of Wisconsin
Eric J. Hohenwalter MD, FSIR Chief, Professor in the Radiology department at Medical College of Wisconsin
Parag J. Patel MD, MS, FSIR Vice Chair, Professor in the Radiology department at Medical College of Wisconsin
William S. Rilling MD, FSIR Vice Chair, Professor in the Radiology department at Medical College of Wisconsin
Sarah B. White MD, MS, FSIR, FCIRSE Associate Dean, Assistant Provost, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Antineoplastic Agents
Carcinoma, Hepatocellular
Chemoembolization, Therapeutic
Female
Follow-Up Studies
Humans
Liver Neoplasms
Male
Middle Aged
Neoplasm Staging
Portasystemic Shunt, Transjugular Intrahepatic
Retrospective Studies
Survival Analysis
Treatment Outcome