Results and Limitations of TACE for Intermediate Stage HCC
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- Saito Natsuhiko
- Department of Radiology, Higashiosaka City Medical Center
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- Nishiohuku Hideyuki
- Department of Diagnostic and Interventional Radiology, Nara Medical University
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- Sato Takeshi
- Department of Diagnostic and Interventional Radiology, Nara Medical University
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- Maeda Shinsaku
- Department of Diagnostic and Interventional Radiology, Nara Medical University
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- Toyoda Syohei
- Department of Diagnostic and Interventional Radiology, Nara Medical University
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- Matsumoto Takeshi
- Department of Diagnostic and Interventional Radiology, Nara Medical University
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- Chanoki Yuto
- Department of Diagnostic and Interventional Radiology, Nara Medical University
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- Oshima Keisuke
- Department of Diagnostic and Interventional Radiology, Nara Medical University
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- Tanaka Toshihiro
- Department of Diagnostic and Interventional Radiology, Nara Medical University
Bibliographic Information
- Other Title
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- Intermediate stage HCCに対するTACEの成績と限界
Abstract
Due to the development of new molecular targeted agents (MTAs) and immune checkpoint inhibitors (ICIs), the treatment strategy for intermediate stage HCC is changing. To clarify the indications for TACE, MTAs/ICIs, or combination therapy, it is necessary to show the results and limitations of TACE for intermediate stage HCC. The Asia-Pacific Primary Liver Cancer Expert Consensus Statement suggested that “beyond up-to-7 criteria” was unsuitable for TACE. However, in clinical practice, the criteria to determine the contraindications to TACE are still controversial. Our data demonstrated that tumor number ≥ 11 was the significant factor. In addition, from Asian countries, up-to-11 criteria and 7-11 criteria, which would replace the up-to-7 criteria, were reported. Achievement of complete response (CR) by TACE can prolong overall survival. Our recent analysis of TACE for beyond up-to-7 criteria cases demonstrated that 57% of patients achieved CR. The significant factor related to CR was up-to-11 criteria. TACE techniques are important to improve efficacy. The 3D-safety-margin is one of the important factors to obtain curability. Current TACE navigation using angio-CT or cone-beam CT is useful to identify the tumor feeding artery. Development of tiny microcatheters and guidewires is also important for superselective TACE. In addition, the recently developed pumping emulsification device with a microporous glass membrane could increase the antitumor effect of selective cTACE.
Journal
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- The Official Journal of the Japanese Society of Interventional Radiology
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The Official Journal of the Japanese Society of Interventional Radiology 36 (3), 236-243, 2022
The Japanese Society of Interventional Radiology
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Keywords
Details 詳細情報について
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- CRID
- 1390574445219606656
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- ISSN
- 21856451
- 13404520
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- Text Lang
- ja
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- Data Source
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- JaLC
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- Abstract License Flag
- Disallowed