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Concurrent partial splenic embolization with transcatheter arterial chemoembolization for hepatocellular carcinoma can maintain hepatic functional reserve
Author(s) -
Ishikawa Toru,
Kubota Tomoyuki,
Horigome Ryoko,
Kimura Naruhiro,
Honda Hiroki,
Iwanaga Akito,
Seki Keiichi,
Honma Terasu,
Yoshida Toshiaki
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12222
Subject(s) - hepatocellular carcinoma , medicine , transcatheter arterial chemoembolization , gastroenterology , cirrhosis , embolization , population , radiology , environmental health
Aim Hepatocellular carcinoma ( HCC ) is frequently complicated with cirrhosis, and it is not unusual for treatment options to be limited as a result of pancytopenia due to hypersplenism. Partial splenic embolization ( PSE ) has been performed for thrombocytopenia resulting from hypersplenism. We studied the efficacy in terms of hepatic functional reserve and safety in patients who underwent concurrent transcatheter arterial chemoembolization ( TACE ) with PSE for HCC . Methods The study population consisted of 101 HCC patients with thrombocytopenia. Fifty‐three patients were treated with concurrent TACE / PSE ( PSE group), and the remaining 48 TACE patients without PSE (non‐ PSE group) were investigated hepatic functional reserve. Results Platelet counts were significantly higher in the PSE group after 2 weeks, 2 months and 6 months after TACE than the non‐ PSE group. C hild– P ugh score significantly deteriorated from 7.13 ± 1.16 to 7.60 ± 1.20 at 2 weeks, to 7.71 ± 1.25 at 2 months, and 7.71 ± 1.35 at 6 weeks after TACE in the non‐ PSE group. Hence, it worsened from 7.04 ± 1.05 to 7.21 ± 0.99 at 2 weeks temporally, but improved to 7.00 ± 1.17 after 2 months and 6.70 ± 1.16 at 6 weeks after TACE in the PSE group. Conclusion Thrombocytopenia has been improved and treatment continued using concurrent PSE . In addition, hepatic functional reserve could be maintained even after treatment for HCC . Concurrent TACE and PSE for HCC with thrombocytopenia can be expected to help maintain hepatic reserve, and may contribute to improving the prognosis of HCC .