• Carcinoma
• Chemoembolization
• Microspheres
• Survival analysis
• hepatocellular
• therapeutic

• conventional transarterial chemoembolization
• drug-eluting bead transarterial chemoembolization
• efficacy
• hepatocellular carcinoma
• hepatoma
• liver cancer
• safety

• Carcinoma; Hepatocellular
• Pain
• Prediction model
• Risk factors
• Transcatheter arterial chemoembolization

• YHDHL202010 Yantai Yuhuangding Hospital
• YHDHL202010 Yantai Yuhuangding Hospital
• YHDHL202010 Yantai Yuhuangding Hospital
• YHDHL202010 Yantai Yuhuangding Hospital
• YHDHL202010 Yantai Yuhuangding Hospital

Liver cancer is a malignant tumor with high morbidity and mortality. Transcatheter arterial chemoembolization (TACE) is the main method for surgically unresectable liver cancer. In recent years, drug-loaded microspheres have been gradually applied in TACE technology. There are some controversies about the therapeutic effects of drug-loaded microspheres TACE (D-TACE) and traditional TACE.

To explore the short-term efficacy of D-TACE and traditional TACE in the treatment of advanced liver cancer.

The clinical data of 73 patients with advanced liver cancer admitted to the First and Sixth Medical Centers of Chinese PLA General Hospital from January 2017 to October 2019 were retrospectively analyzed. Among them, 15 patients were treated with D-TACE, and 58 patients were treated with traditional TACE. Clinical baseline characteristics, perioperative laboratory indices, postoperative adverse reactions and postoperative complications were compared between the two groups.

There was no statistical difference between the two groups for the postoperative response: The highest postoperative body temperature of the drug-loaded microsphere group was 38.0 ± 0.9℃ and the postoperative highest body temperature of the traditional TACE group was 38.3 ± 0.7℃ (t = -1.414, P = 0.162). For the 24 h postoperative nausea and vomiting after surgery in terms of scoring and postoperative pain scores, the traditional TACE group was higher than the drug-loaded microsphere group (χ² = 14.33, P = 0.014; χ² = 32.967, P = 0.000) and the two groups had significant statistical differences. The disease control rate at 3 mo after treatment in the drug-loaded microsphere group was 60% and the disease control rate at 3 mo after treatment in the traditional TACE group was 75.9% (χ² = 4.091, P = 0.252). There was no statistical difference between the two groups of data. During the follow-up period, the number of interventional treatments received was once in the drug-loaded microsphere group and the traditional TACE group received an average of 1.48 treatments (χ² = 10.444 P = 0.005). There was a statistical difference between the two groups.

Compared with traditional TACE, D-TACE may have some advantages in the treatment of advanced hepatocellular carcinoma with a large tumor load in the short term, but the long-term clinical efficacy needs additional follow-up studies. In addition, compared with the traditional group, the patients in the drug-loaded microsphere group had better subjective tolerance and could reduce the number of interventional treatments. Therefore, D-TACE is worthy of clinical promotion.

• Primary liver cancer
• Hepatocellular carcinoma
• Drug-loaded microsphere transcatheter arterial chemoembolization
• Traditional transcatheter arterial chemoembolization
• Treatment
• Short-term efficacy

• Incidence
• liver cancer
• socio-economic
• sorafenib
• survival
• therapy

The aim of this retrospective study was to evaluate the safety and efficacy of patients with hepatocellular carcinoma treated with drug-eluting bead with doxorubicin transarterial chemoembolization (DEBDOX-TACE) in Taiwan.

We retrospectively investigated 630 hepatocellular carcinoma patients who underwent DEBDOX-TACE in multiple institutions from 2011 to 2016 in Taiwan. Tumor response was assessed per modified response evaluation criteria in solid tumors, overall survival, and safety.

This study included 630 patients who underwent DEBDOX-TACE, participants’ mean age was 66 years, 68.1% males and 15.6% females. The mean doxorubicin dose administered via DEBDOX-TACE was 56 mg. Complete and partial response rates were 14.6% and 49.2%, respectively, with a disease control rate of 84.6%. The median overall survival was 29.2 months. The most common post-embolization symptom was abdominal pain (22.4%). No hepatic encephalopathy and no procedure-related death were found.

Real-world data from Taiwan demonstrated that DEBDOX-TACE for hepatocellular carcinoma can achieve high tumor response rate with low adverse events.

• DEBDOX
• chemoembolization
• doxorubicin
• liver cancer

Undifferentiated embryonal sarcoma of the liver (UESL) is a rare and aggressive mesenchymal tumor in children. Herein, we describe our experience in neoadjuvant therapy (NAT) and subsequent surgery for the treatment of UESL in children.

To evaluate the efficacy of NAT and explore a new choice for successful operation of UESL in children.

We retrospectively analyzed six patients newly diagnosed with unresectable UESL who received NAT and then surgery at our center between January 2004 and December 2019. The tumor was considered unresectable if it involved a large part of both lobes of the liver or had invaded the main hepatic vessels or inferior vena cava. The NAT included preoperative transcatheter arterial chemoembolization (TACE) and systemic chemotherapy. The patients were 4 boys and 2 girls with a mean age of 7 years. The longest tumor at presentation ranged from 8.6 to 14.8 cm (mean, 12 cm). Extrahepatic metastases were present in 2 cases. Preoperative systemic chemotherapy was administered 3 wk after TACE. Tumor resection was performed 3 wk after one or two cycles of NAT. The patients received systemic chemotherapy after surgery.

All patients successfully underwent NAT and complete resection. The tumor volumes decreased by 18.2%–68.7%, with a mean decrease of 36% after 1 cycle of NAT (t = 3.524, P = 0.017). According to the Response Evaluation Criteria In Solid Tumors criteria, 4 patients had a partial response and underwent surgery, while 2 had stable disease and received another cycle of NAT before surgery. Massive tumor necrosis was seen on pathological examination of the surgical specimen: > 90% necrosis in two, > 50% necrosis in three, and 25% necrosis in 1, with an average of 71.8%. Post-NAT complications included fever, nausea and vomiting, and mild bone marrow suppression. Elevated alanine transaminase levels occurred in all patients, which returned to normal within 7–10 d after treatment. No cardiac or renal toxicity, severe hepatic dysfunction, bleeding and non-target embolization were observed in the patients. The median follow-up period was 8 years with an overall survival of 100%.

NAT effectively reduced tumor volume, cleared the tumor margin, and caused massive tumor necrosis. This may be a promising choice for successful surgery of UESL in children.

• Undifferentiated embryonal sarcoma of the liver
• Unresectable
• Neoadjuvant therapy
• Transcatheter arterial chemoembolization
• Systemic chemotherapy

Transarterial chemoembolization (TACE) has been considered the standard treatment for intermediate-stage hepatocellular carcinoma (HCC). However, intermediate‐stage HCC is highly heterogeneous with a broad population with varying tumour burdens, liver function. This suggests that TACE monotherapy treatment might not be suitable for all patients with intermediate‐stage HCC. The administration of tyrosine kinase inhibitors (TKIs) has become an important treatment option for improving the prognosis of patients with advanced HCC. Over the years, several trials have been conducted to explore the effects of TACE combined with TKIs for intermediate-stage HCC. However, the clinical efficacy is still controversial, and its potential clinical utility needs to be confirmed. This review will focus on the recent progress of TACE combined TKIs for intermediate-stage HCC.

• combination therapy
• hepatocellular carcinoma
• intermediate stage
• transarterial chemoembolization
• tyrosine kinase inhibitors

• chemoembolization
• doxorubicin-eluting beads
• endovascular brachytherapy
• hepatocellular carcinoma
• portal vein
• stents

• National Natural Science Foundation of China

• cone-beam computed tomography
• drug-eluting micro-spheres
• hepatocellular carcinoma
• immunotherapy
• transarterial chemoembolization

The present study aimed to assess the prevalence of vascular lake (VL), its associated factors and correlation with prognosis in hepatocellular carcinoma (HCC) patients treated with drug-eluting bead transarterial chemoembolization (DEB-TACE). 

 A total of 286 primary HCC patients (with 384 treated nodules) receiving DEB-TACE treatment were recruited, and their clinical characteristics were documented. The occurrence of VL was recorded, and treatment responses were assessed according to the modified response evaluation criteria in solid tumor (mRECIST).In terms of treatment response, the total response status (including CR, PR, SD and PD), objective response rate (ORR) and disease control rate (DCR) were elevated in VL patients compared to non-VL patients as well as in VL nodules compared to non-VL nodules. Liver function indexes and adverse events were assessed. Progression-free survival (PFS) and overall survival (OS) were evaluated with the last follow-up date of March 2020. 

The patient-based and nodule-based VL occurrence rates were 17.1% and 16.4%, respectively. Larger tumor size, pseudocapsules and smaller bead size were independently associated with VL occurrence. PFS and OS were more prolonged in VL patients than in non-VL patients, and VL independently correlated with better PFS and OS. For liver function, the liver function indexes before and after DEB-TACE were of no difference between VL patients and non-VL patients. Additionally, the incidences of adverse events were similar between VL patients and non-VL patients.

 VL occurs in 17.1% of HCC patients treated with DEB-TACE, and it is correlated with larger tumor size, pseudocapsule, smaller bead size, more favorable treatment response and better survival.

• drug-eluting bead transarterial chemoembolization
• efficacy
• hepatocellular carcinoma
• related factors
• safety
• vascular lake

• Guangzhou recommendations
• consensus
• hepatocellular carcinoma
• minimally-invasive therapy
• multidisciplinary comprehensive treatment

• Chemotherapy
• immunotherapy
• intra-arterial
• intra-lesional
• intra-tumoral
• loco-regional

• Doxorubicin
• Drug-eluting bead
• Hepatocellular carcinoma
• Therapeutic chemoembolization

• DEB-TACE
• Drug-eluting beads
• Hepatocellular carcinoma
• cTACE