Safety and effectiveness of chemoembolization with drug-eluting beads for advanced-stage hepatocellular carcinoma

Sanjeeva P. Kalva, Melina Pectasides, Raymond Liu, Niranjan Rachamreddy, Shravani Surakanti, Kalpana Yeddula, Suvranu Ganguli, Stephan Wicky, Lawrence S. Blaszkowsky, Andrew X. Zhu

Research output: Contribution to journalArticle

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Abstract

Background: According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, patients with advanced stage (BCLC-C) hepatocellular carcinoma (HCC) are recommended for systemic treatment or palliative therapy. However, chemoembolization with drug-eluting beads (DEB-TACE) has been shown to be safe in high-risk patients. The purpose of our study was to evaluate the safety and effectiveness of DEB-TACE in patients with an advanced-stage HCC. Methods: In this institutional review board-approved, retrospective study, 80 patients with advanced-stage HCC underwent DEB-TACE with doxorubicin. Patients were evaluated for median hospital stay, incidence of Grade 3/4 toxicities, 30-day mortality, progression-free survival (PFS), and overall survival (OS) following DEB-TACE. Univariate and multivariate analysis were performed for predictors of better OS. Results: The median hospital stay following DEB-TACE was 1 day (range: 1-11). The median PFS and OS were 5.1 months [95 % confidence interval (CI): 4.1-7.7] and 13.3 months (95 % CI: 10.1-18.6) respectively. On multivariate analysis ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS. Patients with ECOG PS ≤ 1 demonstrated a median survival of 17.7 months compared with 5.6 months for patients with ECOG PS > 1 (p = 0.025). Multiple DEB-TACE procedures (>2 procedures) were associated with improved survival (26.8 months) compared with patients with one or two procedures (11.4 months, p = 0.01). Portal vein thrombosis or extrahepatic disease had no statistically significant association with OS. Conclusions: DEB-TACE is safe and effective in patients with advanced HCC. ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS.

Original languageEnglish (US)
Pages (from-to)381-387
Number of pages7
JournalCardioVascular and Interventional Radiology
Volume37
Issue number2
DOIs
StatePublished - 2014

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Hepatocellular Carcinoma
Safety
Survival
Pharmaceutical Preparations
Liver Neoplasms
Disease-Free Survival
Length of Stay
Multivariate Analysis
Confidence Intervals
Research Ethics Committees
Portal Vein
Palliative Care
Doxorubicin
Thrombosis
Retrospective Studies
Mortality
Incidence

Keywords

  • Cancer
  • Chemoembolization/chemoembolisation
  • DEB-TACE
  • Hepatocellular carcinoma
  • Interventional oncology
  • Liver/hepatic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Safety and effectiveness of chemoembolization with drug-eluting beads for advanced-stage hepatocellular carcinoma. / Kalva, Sanjeeva P.; Pectasides, Melina; Liu, Raymond; Rachamreddy, Niranjan; Surakanti, Shravani; Yeddula, Kalpana; Ganguli, Suvranu; Wicky, Stephan; Blaszkowsky, Lawrence S.; Zhu, Andrew X.

In: CardioVascular and Interventional Radiology, Vol. 37, No. 2, 2014, p. 381-387.

Research output: Contribution to journalArticle

Kalva, SP, Pectasides, M, Liu, R, Rachamreddy, N, Surakanti, S, Yeddula, K, Ganguli, S, Wicky, S, Blaszkowsky, LS & Zhu, AX 2014, 'Safety and effectiveness of chemoembolization with drug-eluting beads for advanced-stage hepatocellular carcinoma', CardioVascular and Interventional Radiology, vol. 37, no. 2, pp. 381-387. https://doi.org/10.1007/s00270-013-0654-7
Kalva, Sanjeeva P. ; Pectasides, Melina ; Liu, Raymond ; Rachamreddy, Niranjan ; Surakanti, Shravani ; Yeddula, Kalpana ; Ganguli, Suvranu ; Wicky, Stephan ; Blaszkowsky, Lawrence S. ; Zhu, Andrew X. / Safety and effectiveness of chemoembolization with drug-eluting beads for advanced-stage hepatocellular carcinoma. In: CardioVascular and Interventional Radiology. 2014 ; Vol. 37, No. 2. pp. 381-387.
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abstract = "Background: According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, patients with advanced stage (BCLC-C) hepatocellular carcinoma (HCC) are recommended for systemic treatment or palliative therapy. However, chemoembolization with drug-eluting beads (DEB-TACE) has been shown to be safe in high-risk patients. The purpose of our study was to evaluate the safety and effectiveness of DEB-TACE in patients with an advanced-stage HCC. Methods: In this institutional review board-approved, retrospective study, 80 patients with advanced-stage HCC underwent DEB-TACE with doxorubicin. Patients were evaluated for median hospital stay, incidence of Grade 3/4 toxicities, 30-day mortality, progression-free survival (PFS), and overall survival (OS) following DEB-TACE. Univariate and multivariate analysis were performed for predictors of better OS. Results: The median hospital stay following DEB-TACE was 1 day (range: 1-11). The median PFS and OS were 5.1 months [95 {\%} confidence interval (CI): 4.1-7.7] and 13.3 months (95 {\%} CI: 10.1-18.6) respectively. On multivariate analysis ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS. Patients with ECOG PS ≤ 1 demonstrated a median survival of 17.7 months compared with 5.6 months for patients with ECOG PS > 1 (p = 0.025). Multiple DEB-TACE procedures (>2 procedures) were associated with improved survival (26.8 months) compared with patients with one or two procedures (11.4 months, p = 0.01). Portal vein thrombosis or extrahepatic disease had no statistically significant association with OS. Conclusions: DEB-TACE is safe and effective in patients with advanced HCC. ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS.",
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T1 - Safety and effectiveness of chemoembolization with drug-eluting beads for advanced-stage hepatocellular carcinoma

AU - Kalva, Sanjeeva P.

AU - Pectasides, Melina

AU - Liu, Raymond

AU - Rachamreddy, Niranjan

AU - Surakanti, Shravani

AU - Yeddula, Kalpana

AU - Ganguli, Suvranu

AU - Wicky, Stephan

AU - Blaszkowsky, Lawrence S.

AU - Zhu, Andrew X.

PY - 2014

Y1 - 2014

N2 - Background: According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, patients with advanced stage (BCLC-C) hepatocellular carcinoma (HCC) are recommended for systemic treatment or palliative therapy. However, chemoembolization with drug-eluting beads (DEB-TACE) has been shown to be safe in high-risk patients. The purpose of our study was to evaluate the safety and effectiveness of DEB-TACE in patients with an advanced-stage HCC. Methods: In this institutional review board-approved, retrospective study, 80 patients with advanced-stage HCC underwent DEB-TACE with doxorubicin. Patients were evaluated for median hospital stay, incidence of Grade 3/4 toxicities, 30-day mortality, progression-free survival (PFS), and overall survival (OS) following DEB-TACE. Univariate and multivariate analysis were performed for predictors of better OS. Results: The median hospital stay following DEB-TACE was 1 day (range: 1-11). The median PFS and OS were 5.1 months [95 % confidence interval (CI): 4.1-7.7] and 13.3 months (95 % CI: 10.1-18.6) respectively. On multivariate analysis ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS. Patients with ECOG PS ≤ 1 demonstrated a median survival of 17.7 months compared with 5.6 months for patients with ECOG PS > 1 (p = 0.025). Multiple DEB-TACE procedures (>2 procedures) were associated with improved survival (26.8 months) compared with patients with one or two procedures (11.4 months, p = 0.01). Portal vein thrombosis or extrahepatic disease had no statistically significant association with OS. Conclusions: DEB-TACE is safe and effective in patients with advanced HCC. ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS.

AB - Background: According to the Barcelona Clinic Liver Cancer (BCLC) algorithm, patients with advanced stage (BCLC-C) hepatocellular carcinoma (HCC) are recommended for systemic treatment or palliative therapy. However, chemoembolization with drug-eluting beads (DEB-TACE) has been shown to be safe in high-risk patients. The purpose of our study was to evaluate the safety and effectiveness of DEB-TACE in patients with an advanced-stage HCC. Methods: In this institutional review board-approved, retrospective study, 80 patients with advanced-stage HCC underwent DEB-TACE with doxorubicin. Patients were evaluated for median hospital stay, incidence of Grade 3/4 toxicities, 30-day mortality, progression-free survival (PFS), and overall survival (OS) following DEB-TACE. Univariate and multivariate analysis were performed for predictors of better OS. Results: The median hospital stay following DEB-TACE was 1 day (range: 1-11). The median PFS and OS were 5.1 months [95 % confidence interval (CI): 4.1-7.7] and 13.3 months (95 % CI: 10.1-18.6) respectively. On multivariate analysis ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS. Patients with ECOG PS ≤ 1 demonstrated a median survival of 17.7 months compared with 5.6 months for patients with ECOG PS > 1 (p = 0.025). Multiple DEB-TACE procedures (>2 procedures) were associated with improved survival (26.8 months) compared with patients with one or two procedures (11.4 months, p = 0.01). Portal vein thrombosis or extrahepatic disease had no statistically significant association with OS. Conclusions: DEB-TACE is safe and effective in patients with advanced HCC. ECOG PS ≤ 1 and >2 DEB-TACE procedures were associated with better OS.

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KW - Chemoembolization/chemoembolisation

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KW - Hepatocellular carcinoma

KW - Interventional oncology

KW - Liver/hepatic

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