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Bland Embolization of Hepatocellular Carcinoma Using Superabsorbent Polymer Microspheres

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Abstract

The purpose of this study was to investigate the clinical outcomes of bland embolization using superabsorbent polymer microspheres (SAP-TAE) as an initial therapeutic option for previously untreated hepatocellular carcinoma (HCC) ineligible for resection or ablation. Fifty-nine patients with previously untreated HCC unamenable to surgery or ablation underwent bland embolization using 100- to 200-μm reconstituted SAP particles (SAP-TAE) as the initial treatment. SAP-TAE was repeated as needed based on tumor response but was switched to chemoembolization when necessary to control residual or progressive tumor. Early tumor response was assessed by contrast-enhanced CT according to RECIST and EASL criteria 1 month after the initial SAP-TAE. The overall survival was calculated using the Kaplan–Meier method. The overall mean follow-up period was 30.6 months (range, 7–59 months). A total of 121 sessions of SAP-TAE were performed, with 1–5 sessions per patient (mean, 2.1 sessions). The mean period of repeated SAP-TAE was 15.6 months (range, 1–51 months), and it exceeded 1 and 2 years in 32 (54%) and 15 (25%) patients, respectively. Thirteen (22%) patients underwent repeated SAP-TAE alone, and the remaining 46 (78%) patients underwent subsequent chemoembolization. No major complication was observed and postembolization syndrome was minimal after SAP-TAE in all patients. Response rate was 14% and 66% by RECIST and EASL criteria, respectively. Overall survival rates were 100% and 83% at 1 and 2 years, respectively, and median survival time was 30 months. In conclusion, SAP-TAE was a safe and repeatable option as the induction therapy for HCC unamenable to surgery or ablation, despite the high incidence of converting to TACE during the total course.

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Acknowledgments

We appreciate Atsushi Hori, MD, Yoko Kawawa, MD, PhD, and Mrs. Emi Yamashita for their sincere efforts in data collection and editorial assistance.

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Author notes

  1. Yasuhiro Hata

    Present address: Department of Radiology, Kochi Health Sciences Center, Kochi, Japan

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka Suita, Osaka, 565-0871, Japan

    Keigo Osuga, Hiroki Higashihara, Noboru Maeda, Kaname Tomoda & Hironobu Nakamura

  2. Gate Tower Institute for Image Guided Therapy, Osaka, Japan

    Shinichi Hori, Kumiko Hiraishi, Takashi Sugiura & Yasuhiro Hata

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  1. Keigo Osuga
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  2. Shinichi Hori
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  3. Kumiko Hiraishi
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  4. Takashi Sugiura
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  5. Yasuhiro Hata
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  6. Hiroki Higashihara
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  7. Noboru Maeda
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  8. Kaname Tomoda
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  9. Hironobu Nakamura
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Correspondence to Keigo Osuga.

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Osuga, K., Hori, S., Hiraishi, K. et al. Bland Embolization of Hepatocellular Carcinoma Using Superabsorbent Polymer Microspheres. Cardiovasc Intervent Radiol 31, 1108–1116 (2008). https://doi.org/10.1007/s00270-008-9369-6

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  • DOI: https://doi.org/10.1007/s00270-008-9369-6

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