ENDOVASCULAR TREATMENT FOR UNRESECTABLE HEPATOCELLULAR CARCINOMA - TRANSARTERIAL CHEMOEMBOLIZATION (TACE)

Introduction:  Hepatocellular carcinoma (HCC) is now acknowledged as the third leading cause of cancer-related deaths worldwide, with 660,000 people affected annually. Unfortunately, due to the lack of screening programs, HCC is often diagnosed in an advanced stage. Therefore, palliative treatment becomes the main source of therapy for patients in terminal stages of the disease. Transarterial chemoembolization (TACE) is an interventional loco-regional procedure, performed to alleviate symptoms and prolong survival rate in patients with surgically unresectable HCC. TACE combines the administration of chemotherapeutics (doxorubicin, cisplatin and mitomycin C) and embolic agents (lipoidol and gelatin sponge) through the main feeding artery of the tumor. The rationale of this method is to cause necrosis of the tumor tissue while avoiding damage to the surrounding healthy liver. Materials and Methods:  A retrospective analysis was held for the period 2012-2015 that included 12 patients, treated at the St. Marina University Hospital. The study documented information from the patients` medical records. We had 11 patients (91.7%) with HCC and 1 (8.3%) with ChCC (cholangiocarcinoma), with classification based on the Child-Pugh scale. Five out of the 12(41.6%) were with a single, solitary lesion, while 7 (53.3%) were with multifocal lesions, with predominant right hepatic lobe localization in 10 out of 12(83,3%). The aim of this study is to evaluate the outcome of the treatment in those patients. Results:  The comparative analysis between TACE and systemic chemotherapy results proved a significantly better response to the treatment with TACE, with an estimated survival rate of 38 weeks in comparison to 30 weeks in favor of TACE. Conclusion:  TACE is method for palliative patient care which shows better survival rate when compared to conventional treatment. Our study suggests that TACE is more relevant in the treatment of unresectable HCC patients.