Combined treatment of hepatocellular carcinoma with partial splenic embolization and transcatheter hepatic arterial chemoembolization.
OBJECTIVE
To prospectively evaluate the efficacy and safety of partial splenic embolization (PSE) combined with transcatheter hepatic arterial chemoembolization (TACE) in treatment of hepatocellular carcinoma (HCC).


METHODS
Fifty patients suffering from primary HCC associated with hypersplenism caused by cirrhosis were randomly assigned to 2 groups: group A receiving PSE combined with TACE (n = 26) and group B receiving TACE alone (n = 24). Follow-up examinations included calculation of peripheral blood cells (leukcytes, platelets and red blood cells) and treatment-associated complications.


RESULTS
Prior to treatment, there was no significant difference in sex, age, Child-Pugh grade, tumor diameter, mass pathology type and peripheral blood cell counts between the 2 groups. After treatment, leukocyte and platelet counts were significantly higher in group A during the 3-mo follow-up period (P < 0.05), but lower in group B (P < 0.05). Severe complications occurred in 3 patients (11.5%) of group A and in 19 patients (79.2%) of group B (P < 0.05), and there was no significant difference in symptoms of post-embolization syndrome, including abdominal pain, fever, mild nausea and vomiting between the 2 groups (P > 0.05).


CONCLUSIONS
PSE combined with TACE is more effective and safe than TACE alone for patients with HCC associated with hypersplenism caused by cirrhosis.
Huang
Jin-Hua
JH
Department of Imaging and Interventional Radiology, Cancer Center, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China. hjinh@mail.sysu.edu.cn
Gao
Fei
F
Gu
Yang-Kui
YK
Li
Wen-Quan
WQ
Lu
Lian-Wei
LW
D000328:Adult; D001772:Blood Cell Count; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome