Chemoembolization of Hepatocellular Carcinoma with Drug-Eluting Polyethylene Glycol Embolic Agents: Single-Center Retrospective Analysis in 302 Patients

F. Veloso Gomes, J.A. Oliveira, M.T. Correia, N.V. Costa, J. Abrantes, D. Torres, P. Pereira, A.I. Ferreira, J.H. Luz, E. Spaepen, T. Bilhim, É. Coimbra

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Abstract

Purpose: To evaluate the efficacy and safety of transarterial chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents in the treatment of hepatocellular carcinoma (HCC). Materials and Methods: A single-center retrospective study of 302 patients (258 men; 85.4%) with HCC treated during a 20-month period was conducted. The mean patient age was 66 years ± 10; 142 (47%) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4%) stage B disease; 174 (57.6%) had a single HCC tumor, 65 (21.5%) had 2, and 62 (20.9%) had 3 or more. Mean index tumor size was 36.6 mm ± 24.8. One-month follow-up computed tomography (CT) response per modified Response Evaluation Criteria In Solid Tumors and clinical and biochemical safety were analyzed. Progression-free and overall survival were calculated by Kaplan–Meier method. Results: Median follow-up time was 11.9 months (95% confidence interval, 11.0–13.0 mo). One-month follow-up CT revealed complete response in 179 patients (63.2%), partial response in 63 (22.3%), stable disease in 16 (5.7%), and progressive disease in 25 (8.8%). The most frequent complications were postembolization syndrome in 18 patients (6%), liver abscess in 5 (1.7%), and puncture-site hematoma in 3 (1%). Biochemical toxicities occurred in 57 patients (11.6%). Survival analysis at 12 months showed a progression-free survival rate of 65.9% and overall survival rate of 93.5%. Patients who received transplants showed a 57.7% rate of complete pathologic response. Conclusions: Chemoembolization with PEG embolic agents for HCC is safe and effective, achieving an objective response rate of 85.5%. © 2018 SIR
Original languageEnglish
Pages (from-to)841-849
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume29
Issue number6
DOIs
Publication statusPublished - Jun 2018

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Hepatocellular Carcinoma
Pharmaceutical Preparations
Disease-Free Survival
Survival Rate
Tomography
Safety
Liver Abscess
Liver Neoplasms
Survival Analysis
Punctures
Hematoma
Neoplasms
Retrospective Studies
Confidence Intervals
Transplants
Therapeutics

Cite this

Veloso Gomes, F. ; Oliveira, J.A. ; Correia, M.T. ; Costa, N.V. ; Abrantes, J. ; Torres, D. ; Pereira, P. ; Ferreira, A.I. ; Luz, J.H. ; Spaepen, E. ; Bilhim, T. ; Coimbra, É. / Chemoembolization of Hepatocellular Carcinoma with Drug-Eluting Polyethylene Glycol Embolic Agents: Single-Center Retrospective Analysis in 302 Patients. In: Journal of Vascular and Interventional Radiology. 2018 ; Vol. 29, No. 6. pp. 841-849.
@article{9938f35f4d604608a771fa87bf47edb0,
title = "Chemoembolization of Hepatocellular Carcinoma with Drug-Eluting Polyethylene Glycol Embolic Agents: Single-Center Retrospective Analysis in 302 Patients",
abstract = "Purpose: To evaluate the efficacy and safety of transarterial chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents in the treatment of hepatocellular carcinoma (HCC). Materials and Methods: A single-center retrospective study of 302 patients (258 men; 85.4{\%}) with HCC treated during a 20-month period was conducted. The mean patient age was 66 years ± 10; 142 (47{\%}) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4{\%}) stage B disease; 174 (57.6{\%}) had a single HCC tumor, 65 (21.5{\%}) had 2, and 62 (20.9{\%}) had 3 or more. Mean index tumor size was 36.6 mm ± 24.8. One-month follow-up computed tomography (CT) response per modified Response Evaluation Criteria In Solid Tumors and clinical and biochemical safety were analyzed. Progression-free and overall survival were calculated by Kaplan–Meier method. Results: Median follow-up time was 11.9 months (95{\%} confidence interval, 11.0–13.0 mo). One-month follow-up CT revealed complete response in 179 patients (63.2{\%}), partial response in 63 (22.3{\%}), stable disease in 16 (5.7{\%}), and progressive disease in 25 (8.8{\%}). The most frequent complications were postembolization syndrome in 18 patients (6{\%}), liver abscess in 5 (1.7{\%}), and puncture-site hematoma in 3 (1{\%}). Biochemical toxicities occurred in 57 patients (11.6{\%}). Survival analysis at 12 months showed a progression-free survival rate of 65.9{\%} and overall survival rate of 93.5{\%}. Patients who received transplants showed a 57.7{\%} rate of complete pathologic response. Conclusions: Chemoembolization with PEG embolic agents for HCC is safe and effective, achieving an objective response rate of 85.5{\%}. {\circledC} 2018 SIR",
author = "{Veloso Gomes}, F. and J.A. Oliveira and M.T. Correia and N.V. Costa and J. Abrantes and D. Torres and P. Pereira and A.I. Ferreira and J.H. Luz and E. Spaepen and T. Bilhim and {\'E}. Coimbra",
note = "Export Date: 22 June 2018 CODEN: JVIRE Correspondence Address: Veloso Gomes, F.; Interventional Radiology Unit, Hepato-Biliary-Pancreatic and Transplant Center, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Rua da Benefic{\^e}ncia 8, 1050-099, Portugal; email: fvgomes@gmail.com References: EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma (2012) Eur J Cancer, 48, pp. 599-641; Heimbach, J.K., Kulik, L.M., Finn, R., AASLD guidelines for the treatment of hepatocellular carcinoma (2017) Hepatology, 67, pp. 358-380; Gaba, R.C., Lewandowski, R.J., Hickey, R., Transcatheter therapy for hepatic malignancy—standardization of terminology and reporting criteria (2016) J Vasc Interv Radiol, 27, pp. 457-473; de Baere, T., Plotkin, S., Yu, R., Sutter, A., Wu, Y., Cruise, G.M., An in vitro evaluation of four types of drug-eluting microspheres loaded with doxorubicin (2016) J Vasc Interv Radiol, 27, pp. 1425-1431; Aliberti, C., Carandina, R., Sarti, D., Hepatic arterial infusion of polyethylene glycol drug-eluting beads for primary and metastatic liver cancer therapy (2016) Anticancer Res, 36, pp. 3515-3521; Aliberti, C., Carandina, R., Sarti, D., Chemoembolization adopting polyethylene glycol drug-eluting embolics loaded with doxorubicin for the treatment of hepatocellular carcinoma (2017) AJR Am J Roentgenol, 209, pp. 430-434; Lencioni, R., de Baere, T., Burrel, M., Transcatheter treatment of hepatocellular carcinoma with doxorubicin-loaded DC Bead (DEBDOX): technical recommendations (2012) Cardiovasc Intervent Radiol, 35, pp. 980-985; Lencioni, R., Llovet, J.M., Modified RECIST (mRECIST) assessment for hepatocellular carcinoma (2010) Semin Liver Dis, 30, pp. 52-60; Omary, R.A., Bettmann, M.A., Cardella, J.F., Quality improvement guidelines for the reporting and archiving of interventional radiology procedures (2003) J Vasc Interv Radiol, 14, pp. S293-S295; Marques, H.P., Ribeiro, V., Almeida, T., Long-term results of domino liver transplantation for hepatocellular carcinoma using the “double piggy-back” technique: a 13-year experience (2015) Ann Surg, 262, pp. 749-756; Zou, J.H., Zhang, L., Ren, Z.G., Ye, S.L., Efficacy and safety of cTACE versus DEB-TACE in patients with hepatocellular carcinoma: a meta-analysis (2016) J Dig Dis, 17, pp. 510-517; Facciorusso, A., Di Maso, M., Muscatiello, N., Drug-eluting beads versus conventional chemoembolization for the treatment of unresectable hepatocellular carcinoma: a meta-analysis (2016) Dig Liver Dis, 48, pp. 571-577; Xie, Z.B., Wang, X.B., Peng, Y.C., Systematic review comparing the safety and efficacy of conventional and drug-eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma (2014) Hepatol Res, 45, pp. 190-200; Cucchetti, A., Trevisani, F., Cappelli, A., Cost-effectiveness of doxorubicin-eluting beads versus conventional trans-arterial chemo-embolization for hepatocellular carcinoma (2016) Dig Liver Dis, 48, pp. 798-805; Dioguardi Burgio, M., Ronot, M., Bruno, O., Correlation of tumor response on computed tomography with pathological necrosis in hepatocellular carcinoma treated by chemoembolization before liver transplantation (2016) Liver Transpl, 22, pp. 1491-1500; Yeo, D.M., Choi, J.I., Lee, Y.J., Park, M.Y., Chun, H.J., Lee, H.G., Comparison of RECIST, mRECIST, and choi criteria for early response evaluation of hepatocellular carcinoma after transarterial chemoembolization using drug-eluting beads (2014) J Comput Assist Tomogr, 38, pp. 391-397; Bargellini, I., Vignali, C., Cioni, R., Hepatocellular carcinoma: CT for tumor response after transarterial chemoembolization in patients exceeding Milan criteria–selection parameter for liver transplantation (2010) Radiology, 255, pp. 289-300; Golfieri, R., Giampalma, E., Renzulli, M., Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma (2014) Br J Cancer, 111, pp. 255-264; Boatta, E., Corona, M., Cannavale, A., Fanelli, F., Cirelli, C., de Medici, L., Endovascular treatment of hepatocellular carcinoma with drug eluting microparticles (DC-Beads): CT evaluation of response to the treatment (2013) Indian J Radiol Imaging, 23, pp. 126-133; Bargellini, I., Bozzi, E., Campani, D., Modified RECIST to assess tumor response after transarterial chemoembolization of hepatocellular carcinoma: CT-pathologic correlation in 178 liver explants (2013) Eur J Radiol, 82, pp. e212-e218; Nicolini, D., Svegliati-Baroni, G., Candelari, R., Doxorubicin-eluting bead vs conventional transcatheter arterial chemoembolization for hepatocellular carcinoma before liver transplantation (2013) World J Gastroenterol, 19, pp. 5622-5632; Namur, J., Citron, S.J., Sellers, M.T., Embolization of hepatocellular carcinoma with drug-eluting beads: doxorubicin tissue concentration and distribution in patient liver explants (2011) J Hepatol, 55, pp. 1332-1338; Frenette, C.T., Osorio, R.C., Stark, J., Conventional TACE and drug-eluting bead TACE as locoregional therapy before orthotopic liver transplantation: comparison of explant pathologic response (2014) Transplantation, 98, pp. 781-787; Agopian, V.G., Morshedi, M.M., McWilliams, J., Complete pathologic response to pretransplant locoregional therapy for hepatocellular carcinoma defines cancer cure after liver transplantation: analysis of 501 consecutively treated patients (2015) Ann Surg, 262, pp. 536-545; Beal, E.W., Dittmar, K.M., Hanje, A.J., Pretransplant locoregional therapy for hepatocellular carcinoma: evaluation of explant pathology and overall survival (2016) Front Oncol, 6, pp. 52-57; Kornberg, A., Witt, U., K{\"u}pper, B., Wildgruber, M., Friess, H., Postinterventional tumor necrosis predicts recurrence-free long-term survival in liver transplant patients with advanced hepatocellular carcinoma (2013) Transplant Proc, 45, pp. 1913-1915; Lammer, J., Malagari, K., Vogl, T., Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study (2010) Cardiovasc Intervent Radiol, 33, pp. 41-52; Malagari, K., Pomoni, M., Spyridopoulos, T.N., Safety profile of sequential transcatheter chemoembolization with DC Bead™: results of 237 hepatocellular carcinoma (HCC) patients (2011) Cardiovasc Intervent Radiol, 34, pp. 774-785; Lima, M., Dutra, S., Veloso Gomes, F., Bilhim, T., Coimbra, E., Risk factors for the development of postembolization syndrome after transarterial chemoembolization for hepatocellular carcinoma treatment (2018) Acta Med Port, 31, pp. 22-29",
year = "2018",
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language = "English",
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pages = "841--849",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
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Chemoembolization of Hepatocellular Carcinoma with Drug-Eluting Polyethylene Glycol Embolic Agents: Single-Center Retrospective Analysis in 302 Patients. / Veloso Gomes, F.; Oliveira, J.A.; Correia, M.T.; Costa, N.V.; Abrantes, J.; Torres, D.; Pereira, P.; Ferreira, A.I.; Luz, J.H.; Spaepen, E.; Bilhim, T.; Coimbra, É.

In: Journal of Vascular and Interventional Radiology, Vol. 29, No. 6, 06.2018, p. 841-849.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chemoembolization of Hepatocellular Carcinoma with Drug-Eluting Polyethylene Glycol Embolic Agents: Single-Center Retrospective Analysis in 302 Patients

AU - Veloso Gomes, F.

AU - Oliveira, J.A.

AU - Correia, M.T.

AU - Costa, N.V.

AU - Abrantes, J.

AU - Torres, D.

AU - Pereira, P.

AU - Ferreira, A.I.

AU - Luz, J.H.

AU - Spaepen, E.

AU - Bilhim, T.

AU - Coimbra, É.

N1 - Export Date: 22 June 2018 CODEN: JVIRE Correspondence Address: Veloso Gomes, F.; Interventional Radiology Unit, Hepato-Biliary-Pancreatic and Transplant Center, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Rua da Beneficência 8, 1050-099, Portugal; email: fvgomes@gmail.com References: EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma (2012) Eur J Cancer, 48, pp. 599-641; Heimbach, J.K., Kulik, L.M., Finn, R., AASLD guidelines for the treatment of hepatocellular carcinoma (2017) Hepatology, 67, pp. 358-380; Gaba, R.C., Lewandowski, R.J., Hickey, R., Transcatheter therapy for hepatic malignancy—standardization of terminology and reporting criteria (2016) J Vasc Interv Radiol, 27, pp. 457-473; de Baere, T., Plotkin, S., Yu, R., Sutter, A., Wu, Y., Cruise, G.M., An in vitro evaluation of four types of drug-eluting microspheres loaded with doxorubicin (2016) J Vasc Interv Radiol, 27, pp. 1425-1431; Aliberti, C., Carandina, R., Sarti, D., Hepatic arterial infusion of polyethylene glycol drug-eluting beads for primary and metastatic liver cancer therapy (2016) Anticancer Res, 36, pp. 3515-3521; Aliberti, C., Carandina, R., Sarti, D., Chemoembolization adopting polyethylene glycol drug-eluting embolics loaded with doxorubicin for the treatment of hepatocellular carcinoma (2017) AJR Am J Roentgenol, 209, pp. 430-434; Lencioni, R., de Baere, T., Burrel, M., Transcatheter treatment of hepatocellular carcinoma with doxorubicin-loaded DC Bead (DEBDOX): technical recommendations (2012) Cardiovasc Intervent Radiol, 35, pp. 980-985; Lencioni, R., Llovet, J.M., Modified RECIST (mRECIST) assessment for hepatocellular carcinoma (2010) Semin Liver Dis, 30, pp. 52-60; Omary, R.A., Bettmann, M.A., Cardella, J.F., Quality improvement guidelines for the reporting and archiving of interventional radiology procedures (2003) J Vasc Interv Radiol, 14, pp. S293-S295; Marques, H.P., Ribeiro, V., Almeida, T., Long-term results of domino liver transplantation for hepatocellular carcinoma using the “double piggy-back” technique: a 13-year experience (2015) Ann Surg, 262, pp. 749-756; Zou, J.H., Zhang, L., Ren, Z.G., Ye, S.L., Efficacy and safety of cTACE versus DEB-TACE in patients with hepatocellular carcinoma: a meta-analysis (2016) J Dig Dis, 17, pp. 510-517; Facciorusso, A., Di Maso, M., Muscatiello, N., Drug-eluting beads versus conventional chemoembolization for the treatment of unresectable hepatocellular carcinoma: a meta-analysis (2016) Dig Liver Dis, 48, pp. 571-577; Xie, Z.B., Wang, X.B., Peng, Y.C., Systematic review comparing the safety and efficacy of conventional and drug-eluting bead transarterial chemoembolization for inoperable hepatocellular carcinoma (2014) Hepatol Res, 45, pp. 190-200; Cucchetti, A., Trevisani, F., Cappelli, A., Cost-effectiveness of doxorubicin-eluting beads versus conventional trans-arterial chemo-embolization for hepatocellular carcinoma (2016) Dig Liver Dis, 48, pp. 798-805; Dioguardi Burgio, M., Ronot, M., Bruno, O., Correlation of tumor response on computed tomography with pathological necrosis in hepatocellular carcinoma treated by chemoembolization before liver transplantation (2016) Liver Transpl, 22, pp. 1491-1500; Yeo, D.M., Choi, J.I., Lee, Y.J., Park, M.Y., Chun, H.J., Lee, H.G., Comparison of RECIST, mRECIST, and choi criteria for early response evaluation of hepatocellular carcinoma after transarterial chemoembolization using drug-eluting beads (2014) J Comput Assist Tomogr, 38, pp. 391-397; Bargellini, I., Vignali, C., Cioni, R., Hepatocellular carcinoma: CT for tumor response after transarterial chemoembolization in patients exceeding Milan criteria–selection parameter for liver transplantation (2010) Radiology, 255, pp. 289-300; Golfieri, R., Giampalma, E., Renzulli, M., Randomised controlled trial of doxorubicin-eluting beads vs conventional chemoembolisation for hepatocellular carcinoma (2014) Br J Cancer, 111, pp. 255-264; Boatta, E., Corona, M., Cannavale, A., Fanelli, F., Cirelli, C., de Medici, L., Endovascular treatment of hepatocellular carcinoma with drug eluting microparticles (DC-Beads): CT evaluation of response to the treatment (2013) Indian J Radiol Imaging, 23, pp. 126-133; Bargellini, I., Bozzi, E., Campani, D., Modified RECIST to assess tumor response after transarterial chemoembolization of hepatocellular carcinoma: CT-pathologic correlation in 178 liver explants (2013) Eur J Radiol, 82, pp. e212-e218; Nicolini, D., Svegliati-Baroni, G., Candelari, R., Doxorubicin-eluting bead vs conventional transcatheter arterial chemoembolization for hepatocellular carcinoma before liver transplantation (2013) World J Gastroenterol, 19, pp. 5622-5632; Namur, J., Citron, S.J., Sellers, M.T., Embolization of hepatocellular carcinoma with drug-eluting beads: doxorubicin tissue concentration and distribution in patient liver explants (2011) J Hepatol, 55, pp. 1332-1338; Frenette, C.T., Osorio, R.C., Stark, J., Conventional TACE and drug-eluting bead TACE as locoregional therapy before orthotopic liver transplantation: comparison of explant pathologic response (2014) Transplantation, 98, pp. 781-787; Agopian, V.G., Morshedi, M.M., McWilliams, J., Complete pathologic response to pretransplant locoregional therapy for hepatocellular carcinoma defines cancer cure after liver transplantation: analysis of 501 consecutively treated patients (2015) Ann Surg, 262, pp. 536-545; Beal, E.W., Dittmar, K.M., Hanje, A.J., Pretransplant locoregional therapy for hepatocellular carcinoma: evaluation of explant pathology and overall survival (2016) Front Oncol, 6, pp. 52-57; Kornberg, A., Witt, U., Küpper, B., Wildgruber, M., Friess, H., Postinterventional tumor necrosis predicts recurrence-free long-term survival in liver transplant patients with advanced hepatocellular carcinoma (2013) Transplant Proc, 45, pp. 1913-1915; Lammer, J., Malagari, K., Vogl, T., Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study (2010) Cardiovasc Intervent Radiol, 33, pp. 41-52; Malagari, K., Pomoni, M., Spyridopoulos, T.N., Safety profile of sequential transcatheter chemoembolization with DC Bead™: results of 237 hepatocellular carcinoma (HCC) patients (2011) Cardiovasc Intervent Radiol, 34, pp. 774-785; Lima, M., Dutra, S., Veloso Gomes, F., Bilhim, T., Coimbra, E., Risk factors for the development of postembolization syndrome after transarterial chemoembolization for hepatocellular carcinoma treatment (2018) Acta Med Port, 31, pp. 22-29

PY - 2018/6

Y1 - 2018/6

N2 - Purpose: To evaluate the efficacy and safety of transarterial chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents in the treatment of hepatocellular carcinoma (HCC). Materials and Methods: A single-center retrospective study of 302 patients (258 men; 85.4%) with HCC treated during a 20-month period was conducted. The mean patient age was 66 years ± 10; 142 (47%) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4%) stage B disease; 174 (57.6%) had a single HCC tumor, 65 (21.5%) had 2, and 62 (20.9%) had 3 or more. Mean index tumor size was 36.6 mm ± 24.8. One-month follow-up computed tomography (CT) response per modified Response Evaluation Criteria In Solid Tumors and clinical and biochemical safety were analyzed. Progression-free and overall survival were calculated by Kaplan–Meier method. Results: Median follow-up time was 11.9 months (95% confidence interval, 11.0–13.0 mo). One-month follow-up CT revealed complete response in 179 patients (63.2%), partial response in 63 (22.3%), stable disease in 16 (5.7%), and progressive disease in 25 (8.8%). The most frequent complications were postembolization syndrome in 18 patients (6%), liver abscess in 5 (1.7%), and puncture-site hematoma in 3 (1%). Biochemical toxicities occurred in 57 patients (11.6%). Survival analysis at 12 months showed a progression-free survival rate of 65.9% and overall survival rate of 93.5%. Patients who received transplants showed a 57.7% rate of complete pathologic response. Conclusions: Chemoembolization with PEG embolic agents for HCC is safe and effective, achieving an objective response rate of 85.5%. © 2018 SIR

AB - Purpose: To evaluate the efficacy and safety of transarterial chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents in the treatment of hepatocellular carcinoma (HCC). Materials and Methods: A single-center retrospective study of 302 patients (258 men; 85.4%) with HCC treated during a 20-month period was conducted. The mean patient age was 66 years ± 10; 142 (47%) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4%) stage B disease; 174 (57.6%) had a single HCC tumor, 65 (21.5%) had 2, and 62 (20.9%) had 3 or more. Mean index tumor size was 36.6 mm ± 24.8. One-month follow-up computed tomography (CT) response per modified Response Evaluation Criteria In Solid Tumors and clinical and biochemical safety were analyzed. Progression-free and overall survival were calculated by Kaplan–Meier method. Results: Median follow-up time was 11.9 months (95% confidence interval, 11.0–13.0 mo). One-month follow-up CT revealed complete response in 179 patients (63.2%), partial response in 63 (22.3%), stable disease in 16 (5.7%), and progressive disease in 25 (8.8%). The most frequent complications were postembolization syndrome in 18 patients (6%), liver abscess in 5 (1.7%), and puncture-site hematoma in 3 (1%). Biochemical toxicities occurred in 57 patients (11.6%). Survival analysis at 12 months showed a progression-free survival rate of 65.9% and overall survival rate of 93.5%. Patients who received transplants showed a 57.7% rate of complete pathologic response. Conclusions: Chemoembolization with PEG embolic agents for HCC is safe and effective, achieving an objective response rate of 85.5%. © 2018 SIR

U2 - 10.1016/j.jvir.2018.02.004

DO - 10.1016/j.jvir.2018.02.004

M3 - Article

VL - 29

SP - 841

EP - 849

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 6

ER -