Læknablaðið - 15.06.2012, Page 16

Loco-regional therapy for liver malignancy in lceland
Bjarnason ThA', Bjarnason H1'2, Bergmann OM' 3, Thorisson HM1'4'5
Background and aims: Transarterial chemoembolization (TACE) is a
loco-regional therapy performed to treat tumors in the liver. The branch
of the hepatic artery supplying the tumor is catheterized and a mixture
of iodized oil, chemotheraputic agents and PVA embolic materials
infused. TACE is a palliative treatment of unresectable cancer in the
liver but can also be employed as adjunctive therapy to liver resection
and/or radiofrequency ablation. The procedure can in certain instances
downstage the disease and provide a bridge to liver transplantation.
The aim of this study was to evaluate outcome in patients that have
undergone loco-regional therapy in lceland and the frequency and
severity of complications related to the procedure.
Material and methods: All lcelandic patients that had undergone
TACE, transarterial chemotherapy or bland embolization of liver tumors
between 1 May 2007 and 1 March 2011 were included in the study.
Results: Eighteen TACE, six transarterial chemotherapy treatments
and two bland embolizations were performed on nine patients
withhepatocellular carcinoma (HCC), and three patients with carcinoid
metastases in the liver. Mean-survival of patients with HCC was 15.2
months. Survival of patients with carcinoid metastases was between
61 and 180 months. Complete response was achieved twice and partial
response fourtimes. The disease remained stable after eleven pro-
cedures but progressed after three procedures. Minor complications
were diagnosed in 6 of 26 procedures and one major complication. No
patient suffered from liver failure due to the procedure. Of the 9 HCC
patients, 1 patient was on the liver transplant list before TACE and later
underwent successful transplantation. Additionally, 3 of the remaining 8
patients were downstaged and put on to the transplant list.
Key words: Transarterial chemoembolization (TACE), hepatocellular carcinoma (HCC), carcinoid, interventional radiology, loco-regional therapy, bland embo-
lization, transarterial chemotherapy.
Correspondence: Hjalti MárÞórisson hjaltimt@landspitali.is
'Faculty of Medicine, Univerity of lceland, 2Department of Radiology, Mayo Clinic, Rochester MN, 3Department of Gastro-enterology and4Departmentof
Radiology, Landspitali - University Hospital. 5Yale School of Medicine, New Haven CT
340 LÆKNAblaðið 2012/98