Journal of vascular and interventional radiology : JVIR · 2026
Lipiodol-Based Balloon-Occluded Transcatheter Arterial Chemoembolization Can Be a Curative Treatment Option for Hepatocellular Carcinoma.
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Gwon Dong Il, Kim Jin Hyoung, Chu Hee Ho, Kim Gun Ha, Kim Jihoon, Im Byung Soo, Ko Gi-Young, Yoon Hyun-Ki
Аннотация
PURPOSE: To investigate whether ethiodized oil-based balloon-occluded transcatheter arterial chemoembolization (B-TACE) could be a curative treatment option for hepatocellular carcinoma (HCC) on the basis of pathological evaluation and clinical follow-up results.
MATERIALS AND METHODS: Eighty-two patients who presented with treatment-naive HCC between September 2018 and January 2024 were included in this single-center retrospective study. Radiological evaluations of oily subsegmentectomy, defined as necrotic area that includes the entire ethiodized oil-laden HCC and peritumoral liver parenchyma with absent perfusion on arterial and portal venous image, were performed.
RESULTS: Subsegmental B-TACE was technically successful in all 82 patients with a single HCC (mean diameter, 36 mm; range, 18-65 mm). A complete response (CR) and oily subsegmentectomy on first follow-up computed tomography (CT) were observed in 81 (98.8%) and 33 (40.2%) patients, respectively. Curative response, including pathological complete necrosis (36 of 39) and CR without local recurrence (LR) (28 of 43), was achieved during follow-up in 64 (78%) of 82 patients. During the median follow-up of 39.1 months, 14 HCCs (32.6%) demonstrated LR. All 33 patients with oily subsegmentectomy showed pathological complete necrosis (n = 19), and none demonstrated any LR (n = 14). Univariate log-rank analysis showed that the oily subsegmentectomy-positive group had a significantly lower LR rate than the oily subsegmentectomy-negative group (P = .013).
CONCLUSIONS: Ethiodized oil-based subsegmental B-TACE is an effective method with a high initial CR rate in patients with a single HCC. Oily subsegmentectomy on first follow-up CT is a good predictor of complete necrosis of HCC. Therefore, ethiodized oil-based B-TACE can be considered a curative treatment option in selected patients showing oily subsegmentectomy.
MATERIALS AND METHODS: Eighty-two patients who presented with treatment-naive HCC between September 2018 and January 2024 were included in this single-center retrospective study. Radiological evaluations of oily subsegmentectomy, defined as necrotic area that includes the entire ethiodized oil-laden HCC and peritumoral liver parenchyma with absent perfusion on arterial and portal venous image, were performed.
RESULTS: Subsegmental B-TACE was technically successful in all 82 patients with a single HCC (mean diameter, 36 mm; range, 18-65 mm). A complete response (CR) and oily subsegmentectomy on first follow-up computed tomography (CT) were observed in 81 (98.8%) and 33 (40.2%) patients, respectively. Curative response, including pathological complete necrosis (36 of 39) and CR without local recurrence (LR) (28 of 43), was achieved during follow-up in 64 (78%) of 82 patients. During the median follow-up of 39.1 months, 14 HCCs (32.6%) demonstrated LR. All 33 patients with oily subsegmentectomy showed pathological complete necrosis (n = 19), and none demonstrated any LR (n = 14). Univariate log-rank analysis showed that the oily subsegmentectomy-positive group had a significantly lower LR rate than the oily subsegmentectomy-negative group (P = .013).
CONCLUSIONS: Ethiodized oil-based subsegmental B-TACE is an effective method with a high initial CR rate in patients with a single HCC. Oily subsegmentectomy on first follow-up CT is a good predictor of complete necrosis of HCC. Therefore, ethiodized oil-based B-TACE can be considered a curative treatment option in selected patients showing oily subsegmentectomy.