Skip to main content
SpringerLink
Log in

Hepatocellular carcinoma with blood supply from parasitized omental artery: Angiographic appearance and chemoembolization

  • Original Article
  • Published:
Chinese Journal of Cancer Research

Abstract

Objective

To analyze angiographic appearance of hepatocellular carcinoma (HCC) with blood supply from parasitized omental artery (POA), and evaluate the technical feasibility, safety and therapeutic efficacy of chemoembolization via the POAs.

Methods

A total of 1,221 HCC patients who had undergone chemoembolization procedures were evaluated retrospectively. The evaluated indexes included the incidence rate of POAs, success rate of superselective catheterization, post-reaction after chemoembolization, and the cumulative survival rates.

Results

Totally 1,221 HCC patients had undergone 3,639 chemoembolization procedures, and 32 patients with POAs were enrolled, with 97 POAs found in 76 angiography procedures, giving an incidence rate of 2.09%. POA was observed mostly at the right lobe and left medial lobe except the segment II, and 62 POAs underwent superselective catheterization with microcatheter, giving a success rate of 63.9%. The angiographic appearance was: (1) hypertrophic POAs participating in tumor staining (n=28); (2) stiff and distorted POA (n=11), displaced due to tumor’s oppression (n=8); and (3) defective tumor staining close to either gastrocolic omentum distribution or liver capsule (n=7). In 19 patients, chemoembolization via POAs was performed successfully (A group), while the remaining 13 patients failed (B group). Except 1 acute edema pancreatitis case, no serious complication was recorded. The cumulative survival rates of 6-, 12-, 18- and 24-month were 78.9%, 47.4%, 31.6% and 21.1% respectively for A group; correspondingly, 61.5%, 30.8%, 15.4% and 7.7%% for B group, in which 2 patients died of ruptured HCC.

Conclusion

Chemoembolization with microcatheter via POAs is a relatively safe, feasible and valuable method.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatology 2003; 37:429–442.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  3. Llovet JM, Real MI, Montaña X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359:1734–1739.

    Article  PubMed  Google Scholar 

  4. Shin SW. The current practice of transarterial chemoembolization for the treatment of hepatocellular carcinoma. Korean J Radiol 2009; 10:425–434.

    Article  PubMed  Google Scholar 

  5. Charnsangavej C, Chuang VP, Wallace S, et al. Angiographic classfication of hepatic arterial collaterals. Radiology 1982; 144:485–494.

    PubMed  CAS  Google Scholar 

  6. Kim HC, Chung JW, Lee W, et al. Recognizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcatheter arterial chemoembolization. Radiographics 2005; 25:S25–S39.

    Article  PubMed  Google Scholar 

  7. Miyayama S, Matsui O, Taki K, et al. Extrahepatic blood supply to hepatocellular carcinoma: angiographic demonstration and transcatheter arterial chemoembolization. Cardiovasc Intervent Radiol 2006; 29:39–48.

    Article  PubMed  Google Scholar 

  8. Suh SH, Won JY, Lee DY, et al. Chemoembolization of the left inferior phrenic artery in patients with hepatocellular carcinoma: radiographic findings and clinical outcome. J Vasc Interv Radiol 2005; 16:1741–1745.

    Article  PubMed  Google Scholar 

  9. Kim HC, Chung JW, Choi SH, et al. Internal mammary arteries supplying hepatocellular carcinoma: vascular anatomy at digital subtraction angiography in 97 patients. Radiology 2007; 242:925–932.

    Article  PubMed  Google Scholar 

  10. Miyayama S, Matsui O, Akakura Y, et al. Hepatocellular carcinoma with blood supply from omental branches: treatment with transcatheter arterial embolization. J Vasc Interv Radiol 2001; 12:1285–1290.

    Article  PubMed  CAS  Google Scholar 

  11. Park SI, Lee DY, Won JY, et al. Extrahepatic collateral supply of hepatocellular carcinoma by the intercostal arteries. J Vasc Interv Radiol 2003; 14:461–468.

    Article  PubMed  Google Scholar 

  12. Rajan DK, Ginzburg VE. Hepatocellular carcinoma supplied by the ileocolic branch of the superior mesenteric artery. Clin Radiol 2005; 60:723–726.

    Article  PubMed  CAS  Google Scholar 

  13. Gwon DI, Ko GY, Yoon HK, et al. Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics 2007; 27:687–705.

    Article  PubMed  Google Scholar 

  14. Kim HC, Chung JW, An S, et al. Transarterial chemoembolization of a colic branch of the superior mesenteric artery in patients with unresectable hepatocellular carcinoma. J Vasc Interv Radiol 2011; 22:47–54.

    Article  PubMed  CAS  Google Scholar 

  15. Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology 2005; 42:1208–1236.

    Article  PubMed  Google Scholar 

  16. Forner A, Vilana R, Ayuso C, et al. Diagnosis of hepatic nodules 20 mm or smaller in cirrhosis: Prospective validation of the noninvasive diagnostic criteria for hepatocellular carcinoma. Hepatology 2008; 47:97–104.

    Article  PubMed  Google Scholar 

  17. Chung JW, Kim HC, Yoon JH, et al. Transcatheter arterial chemoembolization of hepatocellular carcinoma: prevalence and causative factors of extrahepatic collateral arteries in 479 patients. Korean J Radiol 2006; 7:257–266.

    Article  PubMed  Google Scholar 

  18. Wang YL, Li MH, Cheng YS, et al. Influential factors and formation of extrahepatic collateral artery in unresectable hepatocellular carcinoma. World J Gastroenterol 2005; 11:2637–2642.

    PubMed  Google Scholar 

  19. Won JY, Lee DY, Lee JT, et al. Supplemental transcatheter arterial chemoembolization through a collateral omental artery: treatment for hepatocellular carcinoma. Cardiovasc Intervent Radiol 2003; 6:136–140.

    Article  Google Scholar 

  20. Wang YL, Li MH, Cheng YS, et al. Influence factors and types of extrahepatic collateral arterial formation in unresectable hepatocellular carcinoma. Jie Ru Fang She Xue Za Zhi (in Chinese) 2005; 14:242–245.

    Google Scholar 

  21. Okazaki M, Higashihara H, Koganemaru F, et al. Intraperitoneal hemorrhage from hepatocellular carcinoma: emergency chemoembolization or embolization. Radiology 1991; 180:647–651.

    PubMed  CAS  Google Scholar 

  22. Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet 2003; 362:1907–1917.

    Article  PubMed  Google Scholar 

  23. Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999; 19:329–338.

    Article  PubMed  CAS  Google Scholar 

  24. Cabibbo G, Enea M, Attanasio M, et al. A meta-analysis of survival rates of untreated patients in randomized clinical trials of hepatocellular carcinoma. Hepatology 2010; 51:1274–1283.

    Article  PubMed  Google Scholar 

  25. Liu Y, Yang R. Preoperative combined with postoperative chemoembolization can improve survival in patients with hepatocellular carcinoma: a single-center study. J Vasc Interv Radiol 2009; 20:472–483.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Interventional Therapy Department, Peking University Cancer Hospital & Institute, Beijing, 100142, China

    Song Gao & Ren-jie Yang

  2. Department of Hepatobiliary Surgery, the General Hospital of the People’s Liberation Army, Beijing, 100853, China

    Jia-hong Dong

Authors
  1. Song Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ren-jie Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jia-hong Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ren-jie Yang.

Additional information

This work was supported by the National “863” S&T Major Project of China (No.2008ZX10002-026) and China International Medical Foundation (No.2008-17).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gao, S., Yang, Rj. & Dong, Jh. Hepatocellular carcinoma with blood supply from parasitized omental artery: Angiographic appearance and chemoembolization. Chin. J. Cancer Res. 24, 207–212 (2012). https://doi.org/10.1007/s11670-012-0207-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11670-012-0207-7

Key words

Search

Navigation