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Preoperative transarterial chemoembolization with drug-eluting beads (DEB-TACE) in patients undergoing conversional hepatectomy: a propensity-score matching analysis

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Patients with colorectal liver metastases (CRLM) who underwent hepatic resection after conversion therapy had a high recurrence rate of nearly 90%. Preoperative DEB-TACE has the potential to prevent postoperative recurrence which has not been elucidated. The objective of this study was to evaluate the safety and efficacy of preoperative DEB-TACE.

Materials and methods

Patients with CRLM who underwent liver resection from June 1, 2016, to June 30, 2021, were collected and those who received conversional hepatectomy were included in this study. Patients with preoperative DEB-TACE were propensity-score matched in a 1:1 ratio to patients without preoperative DEB-TACE. Short-term outcomes and recurrence-free survival (RFS) were compared between the two groups.

Results

After PSM, 44 patients were included in each group. The toxicities of DEB-TACE were mild and could be managed by conservative treatment. Overall response rate (ORR) of conversion therapy (75.0% vs. 81.2%, p = 0.437) and postoperative complication of hepatic resection (27.3% vs. 20.5%, p = 0.453) were similar between the two groups. The median RFS of the DEB-TACE group (10.7 months, 95%CI: 6.6–14.8 months) was significantly longer than that of the control group (8.1 months, 95%CI: 3.4–12.8 months) (HR: 0.60, 95%CI: 0.37–0.95, p = 0.027).

Conclusions

In patients who became resectable after conversion therapy, preoperative DEB-TACE might be a safe option to achieve longer RFS.

Key Points

• This is a propensity-score matching study comparing patients who underwent conversional hepatectomy with or without preoperative DEB-TACE.

• The preoperative DEB-TACE was safe and with mild toxicities (without toxicities more than CTCAE grade 3).

• The preoperative DEB-TACE significantly prolonged the RFS of those patients who underwent conversional hepatectomy (10.7 vs. 8.1 months, p = 0.027).

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Abbreviations

CEA:

Carcinoembryonic antigen

CRC:

Colorectal carcinoma

CRLM:

Colorectal liver metastases

CT:

Computed tomography

DEBIRI:

Irinotecan drug-eluting beads

DEB-TACE:

Transarterial chemoembolization with drug-eluting beads

DFS:

Disease-free survival

HAI:

Hepatic arterial infusion

LRFS:

Liver recurrence-free survival

MDT:

Multi-disciplinary team

MRI:

Magnetic resonance imaging

ORR:

Overall response rate

PSM:

Propensity-score matching

PVI:

Portal vein infusion

RECIST:

Response Evaluation Criteria In Solid Tumors

RFA:

Radiofrequency ablation

RFS:

Recurrence-free survival

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Funding

This study has received funding from The National Natural Science Foundation of China (81602035, 81472228, 82072653); The Shanghai Municipal Health Commission: Shanghai Outstanding Youth Specialist Training Program (Q2017-059); Clinical Science and Technology Innovation Project of Shanghai (SHDC12016104); Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive (17DZ2252600); Youth Fund of Zhongshan Hospital (2019ZSQN28).

Author information

Author notes

  1. Yu Liu, Bo Zhou, Wentao Tang and Donghao Xu contributed equally to this work.

Authors and Affiliations

  1. Colorectal Cancer Centre, Zhongshan Hospital, Fudan University, Shanghai, China

    Yu Liu, Wentao Tang, Donghao Xu, Li Ren, Dexiang Zhu, Guodong He, Ye Wei, Wenju Chang & Jianmin Xu

  2. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

    Yu Liu, Wentao Tang, Donghao Xu, Li Ren, Dexiang Zhu, Guodong He, Ye Wei, Wenju Chang & Jianmin Xu

  3. Shanghai Engineering Research Centre of Colorectal Cancer Minimally Invasive, Shanghai, China

    Yu Liu, Wentao Tang, Li Ren, Dexiang Zhu, Guodong He, Ye Wei, Wenju Chang & Jianmin Xu

  4. Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China

    Bo Zhou & Zhiping Yan

Authors
  1. Yu Liu
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Contributions

Yu Liu, Bo Zhou, Wentao Tang, and Donghao Xu contributed equally to this work.

Corresponding authors

Correspondence to Wenju Chang or Jianmin Xu.

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Guarantor

The scientific guarantor of this publication is Jianmin Xu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Donghao Xu (one of the authors) kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

  • retrospective (a propensity-score matching analysis)

  • observational

  • performed at one institution

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Liu, Y., Zhou, B., Tang, W. et al. Preoperative transarterial chemoembolization with drug-eluting beads (DEB-TACE) in patients undergoing conversional hepatectomy: a propensity-score matching analysis. Eur Radiol 33, 1022–1030 (2023). https://doi.org/10.1007/s00330-022-09063-0

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  • DOI: https://doi.org/10.1007/s00330-022-09063-0

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