Skip to main content

Chemoembolization of hepatic malignancy

Abstract

Treatment of primary and secondary hepatic malignancies with transarterial chemoembolization represents an essential component of interventional oncology. This article discusses patient selection, procedure technique, results, and complications associated with transarterial chemoembolization.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Breedis C, Young G. The blood supply of neoplasms in the liver. Am J Pathol 1954;30:969–977

    PubMed  CAS  Google Scholar 

  2. Liapi E, Georgiades CC, Hong K, et al. Transcatheter arterial chemoembolization: current technique and future promise. Tech Vasc Interv Radiol 2007; 10(1):2–11

    PubMed  Article  Google Scholar 

  3. Kim W, Clark T, Baum RA, et al. Risk factors for liver abscess formation after hepatic chemoembolization. J Vasc Interv Radiol 2001;12 (8):965–968

    PubMed  Article  CAS  Google Scholar 

  4. Patel S, Tuite CM, Mondschein JI, Soulen MC Effectiveness of an aggressive antibiotic regimen for chemoembolization in patients with previous biliary intervention. J Vasc Interv Radiol 2006;17(12):1931–1934

    PubMed  Google Scholar 

  5. Geschwind JH, Kauchik S. Influence of a new prophylactic antibiotic therapy on the incidence of liver abscesses after chemoembolization treatment of liver tumors. J Vasc Interv Radiol 2002; 13:1163–1166

    PubMed  Article  Google Scholar 

  6. Berger DH, Carrasco CH, Hohn DC, et al. Hepatic artery chemoembolization or embolization for primary and metastatic liver tumors: post-treatment management and complications. J Surg Oncol 1995; 60:116–121

    PubMed  Article  CAS  Google Scholar 

  7. Brown DB, Fundakowski CE, Lisker-Melman M, et al. Comparison of MELD and Child-Pugh scores to predict survival after chemoembolization for hepatocellular carcinoma. J Vasc Interv Radiol 2004; 15:1209–1218

    PubMed  Article  Google Scholar 

  8. Georgiades CS, Liapi E, Frangakis C, et al. Prognostic accuracy of 12 liver staging systems in patients with unresectable hepatocellular carcinoma treated with transarterial chemoembolization. J Vasc Interv Radiol 2006;17(10):1619–1624

    PubMed  Google Scholar 

  9. Reed RA, Teitelbaum GP, Daniels JR, et al. Prevalence of infection following hepatic chemoembolization with crosslinked collagen with administration of prophylactic antibiotics. J Vasc Interv Radiol 1994;5:367–371

    PubMed  Article  CAS  Google Scholar 

  10. Ryan JM, Ryan BM, Smith TP. Antibiotic prophylaxis in interventional radiology. J Vasc Interv Radiol 2004;15:547–556

    PubMed  Google Scholar 

  11. Gupta S, Yao JC, Ahrar K, et al. Hepatic artery embolization and chemoembolization for treatment of patients with metastatic carcinoid tumors: the M.D. Anderson experience. Cancer J 2003;9:261–267

    PubMed  Article  Google Scholar 

  12. Brown KT, Koh BY, Brody LA, et al. Particle embolization of hepatic neuroendocrine metastases for control of pain and hormonal symptoms. J Vasc Interv Radiol 1999;10:397–403

    PubMed  Article  CAS  Google Scholar 

  13. Chung J, Park J, Han J, et al. Transcatheter oily chemoembolization of the inferior phrenic artery in hepatocellular carcinoma: the safety and potential therapeutic role. J Vasc Interv Radiol 1998; 9:495–500

    PubMed  Article  CAS  Google Scholar 

  14. Tajima T, Honda H, Kuroiwa T, et al. Pulmonary complications after hepatic artery chemoembolization or infusion via the inferior phrenic artery for primary liver cancer. J Vasc Interv Radiol 2002; 13:893–900

    PubMed  Article  Google Scholar 

  15. Arora R, Soulen M, Haskal Z. Cutaneous complications of hepatic chemoembolization via extrahepatic collaterals. J Vasc Interv Radiol 1999; 10:1351–1356

    PubMed  Article  CAS  Google Scholar 

  16. Leung DA, Goin JE, Sickles C, et al. Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol 2001; 12:321–326

    PubMed  Article  CAS  Google Scholar 

  17. Chen M, Li J, Zhang Y, et al. High-dose iodized oil transcatheter arterial chemoembolization for patients with large hepatocellular carcinoma. World J Gastroenterol 2002;8(1):74–78

    PubMed  Google Scholar 

  18. Higashi S, Tabata N, Kondo KH, et al. Size of lipid microdroplets effects results of hepatic arterial chemotherapy with an anticancer agent in water-in-oil-in-water emulsion to hepatocellular carcinoma. J Pharmacol Exp Ther 1999; 289:816–819

    PubMed  CAS  Google Scholar 

  19. Sasaki Y, Imaoka S, Kasugai H, et al. A new approach to chemoembolization therapy for hepatoma using ethiodized oil, cisplatin, and gelatin sponge. Cancer 1987; 60:1194–1203

    PubMed  Article  CAS  Google Scholar 

  20. Higuchi T, Kikuchi M, Okazaki M. Hepatocellular carcinoma after transcatheter hepatic arterial embolization:a histopathologic study of 84 resected cases. Cancer 1994; 73:2259–2267

    PubMed  Article  CAS  Google Scholar 

  21. Takayasu K, Arii S, Matsuo N, et al. Comparison of CT findings with resected specimens after chemoembolization with iodized oil for hepatocellular carcinoma. AJR 2000; 175:699–704

    PubMed  CAS  Google Scholar 

  22. Kubota K, Hisa N, Nishikawa T, et al. Evaluation of hepatocellular carcinoma after treatment with transcatheter arterial chemoembolization: comparison of Lipiodol-CT, power Doppler sonography, and dynamic MRI. Abdom Imaging 2001; 26:184–190

    PubMed  Article  CAS  Google Scholar 

  23. Chopra S, Dodd GD, Chintapalli KN, et al. Tumor recurrence after radiofrequency thermal ablation of hepatic tumors: spectrum of findings on dual phase contrast-enhanced CT. AJR 2001;177:381–387

    PubMed  CAS  Google Scholar 

  24. Barazani Y, Hiatt JR, Tong MJ, Busuttil RW Chronic viral hepatitis and hepatocellular carcinoma. World J Surg 2007; 31:1243–1248

    PubMed  Article  Google Scholar 

  25. El-Serag HB, Mason AC. Risk factors for the rising rates of primary liver cancer in the United States. Arch Int Med 2000; 160:3227–3230

    Article  CAS  Google Scholar 

  26. Rilling WS, Drooz A. Multidisciplinary management of hepatocellular carcinoma. J Vasc Interv Radiol 2002; 13:S259–S263

    PubMed  Article  Google Scholar 

  27. Geschwind JH. Chemoembolization for hepatocellular carcinoma: where does the truth lie? J Vasc Interv Radiol 2002; 13:991–994

    PubMed  Article  Google Scholar 

  28. Lo CM, Ngan H, Tso WK, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002; 35:1164 –1171

    PubMed  Article  CAS  Google Scholar 

  29. Llovet J, Real MI, Montana X, et al. Arterial embolization or chemoembolization versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial. Lancet 2002; 359:1734–1739

    PubMed  Article  Google Scholar 

  30. Cheng B, Jia C, Liu C, et al. Chemoembolization combined with radiofrequency ablation for patients with hepatocellular carcinoma larger than 3 cm. a randomized controlled trial. JAMA 2008; 299 (14): 1669–1677

    PubMed  Article  CAS  Google Scholar 

  31. Landry CS, Scoggins CR, McMaster KM, Martin RC Management of hepatic metastasis of gastrointestinal carcinoid tumors. J Surg Oncol 2008;97:253–258

    PubMed  Article  Google Scholar 

  32. Q. Chu, Hill H., Douglass H. et al. Predictive factors associated with long-term survival in patients with neuroendocrine tumors of the pancreas. Ann Surg Oncol 2002; 9:855–862

    PubMed  Article  Google Scholar 

  33. Murthy R, Kamat P, Nunez R, et al. Yttrium-90 microsphere radioembolotherapy of hepatic metastatic neuroendocrine carcinomas after hepatic arterial embolization. J Vasc Interv Radiol 2008; 19:145–151

    PubMed  Article  Google Scholar 

  34. Madoff DC, Gupta S, Ahrar K, et al. Update on the management of neuroendocrine hepatic metastases. J Vasc Interv Radiol 2006; 17:1235–1250

    PubMed  Google Scholar 

  35. Vogl TJ, Zangos S, Eichler K, Yakoub D, Nabil M Colorectal liver metastases: regional chemotherapy via transarterial chemoembolization (TACE) and hepatic chemoperfucion: an update. Eur Radiol 2007;17:1025–1034

    PubMed  Article  Google Scholar 

  36. Brown DB, Cardella JF, Sacks D, et al. Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy. J Vasc Interv Radiol 2006; 17:225–232

    PubMed  Google Scholar 

  37. Fiorentini G, Aliberti C, Turrisi G, et al. Intraarterial hepatic chemoembolization of liver metastases from colorectal cancer adopting irinotecan-eluting beads: results of a phase II clinical study. In Vivo 2007;21(6):1085–1091

    PubMed  CAS  Google Scholar 

  38. Giroux MF, Baum RA, Soulen MC. Chemoembolization of liver metastasis from breast carcinoma. J Vasc Interv Radiol 2004; 15:289–291

    PubMed  Google Scholar 

  39. Diener-West M, Reynolds SM, Agugliaro DJ, et al. Development of metastatic disease after enrollment in the COMS trials for treatment of choroidal melanoma: collaborative ocular melanoma study group report No. 26. Arch Ophthalmol 2005;123(12):1639–1643

    PubMed  Article  Google Scholar 

  40. Gragoudas ES, Egan KM, Seddon JM, et al. Survival of patients with metastases from uveal melanoma. Ophthalmology 1991;98(3):383–389

    PubMed  CAS  Google Scholar 

  41. Kath R, Hayungs J, Bornfeld N, et al. Prognosis and treatment of disseminated uveal melanoma. Cancer 1993;72(7):2219–2223

    PubMed  Article  CAS  Google Scholar 

  42. Malvigit GM, Charansangavej C, Carrasco CH, et al. Regression of ocular melanoma metastatic to the liver after hepatic artery chemoembolization with cisplatin and polyvinyl sponge. JAMA 1988; 260:974–976

    Article  Google Scholar 

  43. Bedekian AY, Legha SS, Mavligit GM, et al. Treatment of uveal melanoma metastatic to the liver. A review of the M.D. Anderson Cancer Center experience and prognostic factors. Cancer 1995; 76:1665–1670

    Article  Google Scholar 

  44. Sato T, Nathan FE, Berd D, et al. Lack of effects from chemoembolization for liver metastases from uveal melanoma (abstract). Proc Am Soc Clin Oncol 1995; 14:415

    Google Scholar 

  45. Patel K, Sullivan K, Berd D, et al. Chemoembolization of the hepatic artery with BCNU for metastatic uveal melanoma: results of a Phase II study. Melanoma Res 2005;15:297–304

    PubMed  Article  Google Scholar 

  46. Sato T, Sullivan KL, Eschelman DJ, et al. Immunoembolization of malignant liver tumor with GM-CSF and ethiodized oil followed by gelatin sponge pledgets. The final results of a phase I/IIa study. J Clin Oncol 2005;23:16s–169s

    Google Scholar 

  47. Burger I, Hong K, Schulick R, et al. Transcatheter arterial chemoembolization in unresectable cholangiocarcinoma: initial experience in a single institution. J Vasc Interv Radiol 2005; 16:353–361

    PubMed  Google Scholar 

  48. Herber S, Otto G, Schneider J, et al. Transarterial chemoembolization (TACE) for inoperable intrahepatic cholangiocarcinoma. Cardiovasc Interv Radiol 2007;30:1156–1165

    Article  CAS  Google Scholar 

  49. Patel NH, Hahn D, Rapp S, et al. Hepatic artery embolization: factors predisposing to postembolization pain and nausea. J Vasc Interv Radiol 2000; 11:453–460

    PubMed  Article  CAS  Google Scholar 

  50. Brown KT, Nevins AB, Getrajdman GI, et al. Particle embolization for hepatocellularcarcinoma. J Vasc Interv Radiol 1998;9:822–828

    PubMed  Article  CAS  Google Scholar 

  51. Chung J, Park J, Han J, et al. Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization. Radiology 1996; 198:33–40

    PubMed  CAS  Google Scholar 

  52. Song S, Chung JW, Lim HJ, Park JH Nonhepatic arteries originating from the hepatic arteries: angiographic analysis in 250 patients. J Vasc Interv Radiol 2006; 17:461–469

    PubMed  Article  Google Scholar 

  53. Ibukuro K, Tsukiyama T, Mori K, Inoue Y Hepatic falciform ligament artery: angiographic anatomy and clinical importance. Surg Radiol Anat 1999; 20(5):367–371

    Article  Google Scholar 

  54. Zhu LX, Meng XL, Fan ST. Elasticity of small artery in patient with spontaneous rupture of hepatocellular carcinoma. Hepatol Res 2004;29:13-17

    PubMed  Article  Google Scholar 

  55. Sakamoto I, Aso N, Nagaok i K, et al. Complications associated with transcatheter arterial embolization for hepatic tumours. Radiographics 1998;18:605–619

    PubMed  CAS  Google Scholar 

  56. Yu JS, Kim KW, Jeong MG, et al. Predisposing factors of bile duct injury after transcatheter arterial chemoembolization (TACE) for hepatic malignancy. Cardiovasc Intervent Radiol 2002; 25:270–274

    PubMed  Article  Google Scholar 

  57. Narendra Battula, Parthi Srinivasan, Mansoor Madanur, et al. Ruptured hepatocellular carcinoma following chemoembolization: a western experience. Hepatobiliary Pancreat Dis Int 2007; 6: 49–51

    PubMed  Google Scholar 

  58. Demachi H, Matsui O, Kawamori Y, et al. The protective effect of portoarterial shunts after experimental hepatic artery embolization in rats with liver cirrhosis. Cardiovasc Intervent Radiol. 1995;18(2):97–101

    PubMed  Article  CAS  Google Scholar 

  59. Kalva SP, Thabet A, Wicky S. Recent advances in transarterial therapy of primary and secondary liver malignancies. RadioGraphics 2008;28:101–117

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Daniel B. Brown.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Gonsalves, C.F., Brown, D.B. Chemoembolization of hepatic malignancy. Abdom Imaging 34, 557–565 (2009). https://doi.org/10.1007/s00261-008-9446-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-008-9446-y

Keywords

  • Chemoembolization
  • Hepatic malignancy
  • Hepatocellular carcinoma
  • Cirrhosis
  • Liver metastases