Abstract:
:In the 2010 version of the Japan Society of Hepatology (JSH) consensus-based treatment algorithm for the management of hepatocellular carcinoma (HCC), transarterial chemoembolization (TACE) failure/refractoriness was defined assuming the use of superselective lipiodol TACE, which has been widely used worldwide and particularly in Japan, and areas with lipiodol deposition were considered to be necrotic. However, this concept is not well accepted internationally. Furthermore, following the approval of microspheres, an embolic material that does not use lipiodol, in February 2014 in Japan, the phrase 'lipiodol deposition' needed to be changed to 'necrotic lesion or viable lesion'. Accordingly, the respective section in the JSH guidelines was revised to define TACE failure as an insufficient response after ≥2 consecutive TACE procedures that is evident on response evaluation computed tomography or magnetic resonance imaging after 1-3 months, even after chemotherapeutic agents have been changed and/or the feeding artery has been reanalyzed. In addition, the appearance of a higher number of lesions in the liver than that recorded at the previous TACE procedure (other than the nodule being treated) was added to the definition of TACE failure/refractoriness. Following the discussion of other issues concerning the continuous elevation of tumor markers, vascular invasion, and extrahepatic spread, descriptions similar to those in the previous version were approved. The revision of these TACE failure definitions was approved by over 85% of HCC experts.
journal_name
Oncologyjournal_title
Oncologyauthors
Kudo M,Matsui O,Izumi N,Kadoya M,Okusaka T,Miyayama S,Yamakado K,Tsuchiya K,Ueshima K,Hiraoka A,Ikeda M,Ogasawara S,Yamashita T,Minami T,Liver Cancer Study Group of Japan.doi
10.1159/000368142subject
Has Abstractpub_date
2014-01-01 00:00:00pages
22-31eissn
0030-2414issn
1423-0232pii
000368142journal_volume
87 Suppl 1pub_type
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