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Comparison of local recurrence in transcatheter arterial chemoembolization of hepatocellular carcinoma with or without accumulation of iodized oil beyond corona enhancement area: Short-term results Cover

Comparison of local recurrence in transcatheter arterial chemoembolization of hepatocellular carcinoma with or without accumulation of iodized oil beyond corona enhancement area: Short-term results

Open Access
|Dec 2021

Figures & Tables

Figure 1

Flow diagram of patients’ and nodules’ selection.
CTHA = computed tomography during hepatic arteriography; DEB-TACE = drug-eluting beads transcatheter arterial chemoembolization; RFA = radiofrequency ablation; TACE = transcatheter arterial chemoembolization
Flow diagram of patients’ and nodules’ selection. CTHA = computed tomography during hepatic arteriography; DEB-TACE = drug-eluting beads transcatheter arterial chemoembolization; RFA = radiofrequency ablation; TACE = transcatheter arterial chemoembolization

Figure 2

Local tumor recurrence after transcatheter arterial chemoembolization (TACE) in an 82-year-old patient with a hepatocellular carcinoma. (A) Early-phase computed tomography during hepatic arteriography (CTHA) demonstrated a hypervascular nodule in S5. (B) Late-phase CTHA demonstrated the corona enhancement around the tumor (white arrow). (C) Non-contrast-enhanced computed tomography performed immediately after TACE showed dense accumulation of iodized oil throughout the tumor, but not in the entire corona enhancement area. (D) In contrast enhanced magnetic resonance images obtained 4 months after TACE, local recurrence developed around the tumor (black arrow).
Local tumor recurrence after transcatheter arterial chemoembolization (TACE) in an 82-year-old patient with a hepatocellular carcinoma. (A) Early-phase computed tomography during hepatic arteriography (CTHA) demonstrated a hypervascular nodule in S5. (B) Late-phase CTHA demonstrated the corona enhancement around the tumor (white arrow). (C) Non-contrast-enhanced computed tomography performed immediately after TACE showed dense accumulation of iodized oil throughout the tumor, but not in the entire corona enhancement area. (D) In contrast enhanced magnetic resonance images obtained 4 months after TACE, local recurrence developed around the tumor (black arrow).

Figure 3

Complete response after transcatheter arterial chemoembolization (TACE) in a 77-year-old patient with a hepatocellular carcinoma. (A) Early-phase computed tomography during hepatic arteriography (CTHA) demonstrated a hypervacular nodule in S4. (B) Late-phase CTHA demonstrated the corona enhancement around the tumor (white arrow). (C) Non-contrast-enhanced computed tomography performed immediately after TACE showed dense accumulation of iodized oil beyond corona enhancement area. (D) Contrast-enhanced computed tomography performed 15 months after TACE showed no enhancement around the tumor.
Complete response after transcatheter arterial chemoembolization (TACE) in a 77-year-old patient with a hepatocellular carcinoma. (A) Early-phase computed tomography during hepatic arteriography (CTHA) demonstrated a hypervacular nodule in S4. (B) Late-phase CTHA demonstrated the corona enhancement around the tumor (white arrow). (C) Non-contrast-enhanced computed tomography performed immediately after TACE showed dense accumulation of iodized oil beyond corona enhancement area. (D) Contrast-enhanced computed tomography performed 15 months after TACE showed no enhancement around the tumor.

Figure 4

Local tumor recurrence-free rate according to the range of the embolization for transcatheter arterial chemoembolization (TACE). The cumulative 3-, 6-, 12-month tumor local recurrence rates were 2.8%, 2.8%, 8.3%, respectively, for cases with embolization of the entire corona enhancement area, and 20.8%, 45.8%, 75%, respectively, for cases without embolization of the entire corona enhancement area (hazard ratio [HR], 0.079; 95% confidence interval [CI], 0.026–0.24; p < 0.001).
Local tumor recurrence-free rate according to the range of the embolization for transcatheter arterial chemoembolization (TACE). The cumulative 3-, 6-, 12-month tumor local recurrence rates were 2.8%, 2.8%, 8.3%, respectively, for cases with embolization of the entire corona enhancement area, and 20.8%, 45.8%, 75%, respectively, for cases without embolization of the entire corona enhancement area (hazard ratio [HR], 0.079; 95% confidence interval [CI], 0.026–0.24; p < 0.001).

Clinical characteristics of nodules in group A and B

Clinical characteristicsGroup A (n = 36)Group B (n = 24)p value
Age, years*74 (70–79)71 (64–79)0.149
Gender, male/female8/286/180.999
Etiology (HCV/HBV/Alcohol/Unknown)16/8/8/49/5/6/40.912
Child-Pugh classification (A/B)31/519/50.569
BCLC stage(0/A/B)11/20/55/17/20.545
Size of tumor, mm*14.5 (12–21.3)15.5 (11–22)0.757
Thickness of corona enhancement(≤ 2mm/>2mm)17/1910/140.793
AFP, ng/ml*4.9 (2.6–10.6)5.9 (2.7–14.1)0.419
DCP, mAU/mL*26.4 (17.0–49.2)48.8 (25.3–153.9)0.021
Usage of miriplatin, mg*28 (20–38.5)30 (22.4–51.5)0.310

Univariate and multivariate logistic regression analysis for factor affecting local tumor recurrence

FactorUnivariate analysis
Multivariate analysis
Odds ratio (95% CI)p valueOdds ratio (95% CI)p value
Size of tumor (< 20 vs. ≥ 20 mm)0.67 (0.20–2.32)0.577
AFP (< 10 vs. ≥ 10 ng/mL)0.45 (0.13–1.61)0.242
DCP (< 40 vs. ≥ 40 mAU/mL)0.59 (0.18–1.92)0.417
Usage of miriplatin (< 30 vs. ≥ 30 mg)0.70 (0.17–1.89)0.420
Thickness of corona enhancement (≤ 2mm/ > 2mm)0.97 (0.30–3.20)0.999
Degree of iodized oil accumulation (Group A vs. B)0.045 (0.0080–0.20)< 0.0010.042 (0.010–0.17)< 0.001
DOI: https://doi.org/10.2478/raon-2021-0047 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 69 - 75
Submitted on: Aug 12, 2021
Accepted on: Oct 1, 2021
Published on: Dec 22, 2021
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2021 Yukinobu Watanabe, Masahiro Ogawa, Masahiro Kaneko, Mariko Kumagawa, Midori Hirayama, Naoki Matsumoto, Hiroshi Nakagawara, Toshiki Yamamoto, Mitsuhiko Moriyama, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.