title: Safety and efficacy of transarterial chemoembolization in patients with transjugular intrahepatic portosystemic shunts.
abstract: BACKGROUND
  Transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) is an important option as the majority of patients present with advanced disease. Data regarding treatment outcomes in patients who have undergone transjugular intrahepatic portosystemic shunts (TIPS) are limited. The present study seeks to evaluate the safety and efficacy of TACE in HCC patients with a TIPS.
  
  
  METHODS
  A retrospective review identifying patients with HCC and concomitant TIPS who were treated with TACE was performed.
  
  
  RESULTS
  From 1999 to 2014, 16 patients with HCC underwent a total of 27 TACE procedures; eight patients required multiple treatments. The median patient age at the time of the initial TACE was 60.5 years [interquartile range (IQR) : 52.5-67.5] with the majority being male (n = 12, 75%) and Childs-Pugh Class B (n = 12, 75%). At 6 weeks after TACE, 56.3% of patients achieved an objective response rate (complete and partial response) by mRECIST criteria. Clavien Grade 3 or higher complications occurred in 11.1% of TACE procedures. There were no peri-procedural deaths. The median progression-free (PFS) and overall survival (OS) were 9 and 22 months, respectively, when censored for liver transplantation (median follow-up: 11.5 months).
  
  
  CONCLUSIONS
  TACE is an effective treatment strategy for HCC in TIPS patients; albeit may be associated with higher complication rates.
authors.affiliation: Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Miura
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Rilling
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Sarah B
authors.initials: SB
authors.lastname: White
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hieb
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Tutton
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Parag J
authors.initials: PJ
authors.lastname: Patel
authors.affiliation: Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: T Clark
authors.initials: TC
authors.lastname: Gamblin
authors.affiliation: Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hohenwalter
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents