Evaluation of the relationship between hepatocellular carcinoma location and transarterial chemoembolization efficacy

doi:10.3748/wjg.v23.i35.6437

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Sep 21, 2017; 23(35): 6437-6447
Published online Sep 21, 2017. doi: 10.3748/wjg.v23.i35.6437

Evaluation of the relationship between hepatocellular carcinoma location and transarterial chemoembolization efficacy

Shin-ichiro Kumita, Eiji Uchida, Chiaki Kawamoto, Ryusuke Murakami, Hidenori Yamaguchi, Hidemasa Saito, Fumie Sugihara, Tatsuo Ueda, Daisuke Yasui, Fumio Uchiyama, Satoru Murata, Izumi Miki

Izumi Miki, Satoru Murata, Daisuke Yasui, Tatsuo Ueda, Fumie Sugihara, Hidemasa Saito, Ryusuke Murakami, Shin-ichiro Kumita, Department of Radiology, Center of Advanced Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan

Fumio Uchiyama, Department of Radiology, Ebina-Sogo Hospital, Ebina-shi 243-0433, Japan

Hidenori Yamaguchi, Department of Radiology, Tamanagayama Hospital, Nippon Medical School, Tama-shi, Tokyo 206-8523, Japan

Chiaki Kawamoto, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan

Eiji Uchida, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Bunkyo-ku, Tokyo 113-8603, Japan

Author contributions: Miki I and Murata S contributed equally to this work; Murata S designed the research; Miki I, Uchida F, Yasui D, Ueda T, Sugihara F and Saito H and Yamaguchi H, Murakami R performed the research; Miki I and Uchiyama F, Yasui D analyzed the data; Miki I and Murata S wrote the paper; Kawamoto C, Uchida E provided resources; Murata SI and Kumita S oversaw the project.

Institutional review board statement: The study was reviewed and approved by the Nippon Medical School Institutional Review Board.

Informed consent statement: Patients were not required to give informed consent for this study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. For full disclosure, the details of the study are published on the home page of Nippon Medical School.

Conflict-of-interest statement: There are no conflicts of interest to declare.

Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at genji@nms.ac.jp. Participants gave informed consent for data sharing.

Correspondence to: Satoru Murata, MD, PhD, Department of Radiology, Center of Advanced Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. genji@nms.ac.jp

Telephone: +81-3-58146240 Fax: +81-3-56851795

Received: June 6, 2017
Peer-review started: June 7, 2017
First decision: July 13, 2017
Revised: July 25, 2017
Accepted: August 15, 2017
Article in press: August 15, 2017
Published online: September 21, 2017
Processing time: 108 Days and 2.1 Hours

Abstract

AIM

To evaluate the relationship between the location of hepatocellular carcinoma (HCC) and the efficacy of transarterial chemoembolization (TACE).

METHODS

We evaluated 115 patients (127 nodules), excluding recurrent nodules, treated with TACE between January 2011 and June 2014. TACE efficacy was evaluated according to mRECIST. The HCC location coefficient was calculated as the distance from the central portal portion to the HCC center (mm)/liver diameter (mm) on multiplanar reconstruction images rendered (MPR) to visualize bifurcation of the right and left branches of the portal vein and HCC center. The HCC location coefficient was compared between complete response (CR) and non-CR groups in Child-Pugh grade A and B patients.

RESULTS

The median location coefficient of HCC among all nodules, the right lobe, and the medial segment was significantly higher in the CR group than in the non-CR group in the Child-Pugh grade A patients (0.82 vs 0.62, P < 0.001; 0.71 vs 0.59, P < 0.01; 0.81 vs 0.49, P < 0.05, respectively). However, there was no significant difference in the median location coefficient of the HCC in the lateral segment between in the CR and in the non-CR groups (0.67 vs 0.65, P > 0.05). On the other hand, in the Child-Pugh grade B patients, the HCC median location coefficient in each lobe and segment was not significantly different between in the CR and in the non-CR groups.

CONCLUSION

Improved TACE efficacy may be obtained for HCC in the peripheral zone of the right lobe and the medial segment in Child-Pugh grade A patients.

Keywords: Hepatocellular carcinoma location; Transarterial chemoembolization efficacy; Child-Pugh; Modified response evaluation criteria in solid tumors; Central zone; Peripheral zone

Core tip: The relationship between hepatocellular carcinoma (HCC) location and transcatheter arterial chemoembolization (TACE) efficacy was evaluated. In Child-Pugh A, the median location coefficient of HCC among all nodules, right lobe, and medial segment was significantly higher in the complete response (CR) group than in the non-CR group, with no significant differences in the lateral segment. In Child-Pugh B, the median location coefficient of HCC in each lobe and segment was not significantly different between the two groups. Therefore, improved TACE efficacy may be obtained for HCC in the peripheral zone of the right lobe and medial segment in Child-Pugh A patients.