title: Evaluation of extrahepatic collateral arteries in hepatocellular carcinoma in three independent groups in a single center.
abstract: To improve the efficacy of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), this study evaluated the prevalence and causes of extrahepatic arteries (EHAs) and identified feeding arteries in HCCs in three independent clinical groups in a single inverventional radiology center. Between November 2011 and September 2012, 942 cases of HCC were included in this retrospective study. The patients were treated in three independent groups of 285, 301 and 356 patients, respectively. Enhanced computed tomography, enhanced magnetic resonance imaging and digital subtraction angiography were reviewed retrospectively and correlations between the presence of tumor-feeding EHAs and tumor number, size and location in the liver, number of repeat TACE procedures and complications were assessed. There were 698 EHAs in the 942 cases of HCC, with 182, 233 and 283 EHAs in the three independent groups, respectively. Tumor size was associated with EHA formation; the percentages of patients with EHAs were 2.7±3.0, 5.5±0.5, 43.2±4.0, 61.8±5.2 and 93.4±1.8% with tumor sizes of 2-3, 3-5, 5-7, 7-9 and >9 cm, respectively. There were 159±19 EHAs in each group feeding tumors in peripheral locations in the liver, but only 48.7±6.8 in the central zone. The most common EHA was the right inferior phrenic artery, with a mean of 101.0±14.1 per group. The number of EHAs increased proportionally with the number of TACE sessions. The number of EHAs was positively associated with tumor size, peripheral location of the tumor and number of TACE sessions.
authors.affiliation: Department of Oncological and Vascular Interventional Radiology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian 361004, P.R. China.
authors.forename: Yilin
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Interventional Radiology, Provincial Hospital of Fujian, Fuzhou, Fujian 350014, P.R. China ; Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China.
authors.forename: Zhuting
authors.initials: Z
authors.lastname: Fang
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China.
authors.forename: Qingxin
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Oncological and Vascular Interventional Radiology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian 361004, P.R. China.
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Oncological and Vascular Interventional Radiology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian 361004, P.R. China.
authors.forename: Heng
authors.initials: H
authors.lastname: Pan
authors.affiliation: Department of Oncological and Vascular Interventional Radiology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian 361004, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China.
authors.forename: Zhiping
authors.initials: Z
authors.lastname: Yan
keywords: extrahepatic arteries; hepatocellular carcinoma; transcatheter arterial chemoembolization