Maruyama M, Yoshizako T, Nakamura T, Nakamura M, Yoshida R, Kitagaki H

PURPOSE This study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).

METHODS B-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.

RESULTS The LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P<0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann-Whitney test: P<0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P<0.05).

CONCLUSION The LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P<0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

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