Concurrent partial splenic embolization with transcatheter arterial chemoembolization for hepatocellular carcinoma can maintain hepatic functional reserve

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 .