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XV) Interventional Oncology in HCC
Symposium (XV)
INTERVENTIONAL ONCOLOGY IN HCC
NEW ADVANCE IN IR FROM MALAYSIA
Basri Johan Jeet Abdullah Department of Radiology & Nuclear Medicine, Prince Court Medical Centre, Kuala Lumpur, Malaysia Faculty of Health and Medical Sciences, Taylor’s University, Selangor, Malaysia
Tremendous progress has been made in both the technological advances and clinical applications of thermal ablation with improving outcomes. Recent interest of the immunological effects in moderating cellular responses has spurred increased growth of this treatment modality. This interest has been accelerated by the explosion in immunotherapy as a third pillar of clinical oncology. We will discuss how the creation of artificial pneumothorax and use of newer muscle relaxants in general anaesthesia have enhanced the capabilities of thermal ablation i.e. MWA in our practice.
Symposium (XV)
INTERVENTIONAL ONCOLOGY IN HCC
Chia-Ling Chiang Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan
The caudate lobe of the liver located deeply in the central portion of the back, belongs to the Couinard I segment, and is sandwiched in a “valley of blood” among the first, second, and third portal. Primary hepatic tumors or metastases located in the caudate lobe are not infrequent, and caudate lobectomy is technically challenging for many surgeons. Transarterial embolization for HCC at caudate lobe is also one of the most difficult procedures for many IRs due to the complex blood supply to caudate lesions. With the advantage of ablation and imaging resolution, percutaneous radical treatment with RFA has emerged as a novel method for treating caudate lobe tumors. We evaluated the technical feasibility and safety of percutaneous radiofrequency ablation for caudate lobe tumors under CT or US guidance from 2008 to 2016 in our institute, and focused on the technical success rate, potential complications, recurrence rate and technical tips.
Symposium (XV)
INTERVENTIONAL ONCOLOGY IN HCC
HEPATIC ARTERIAL INFUSION CHEMOTHERAPY FOR ADVANCED HEPATOCELLULAR CARCINOMA IN THE ERA OF MOLECULAR TARGETED AGENT-DIVERSITY
Hideki Iwamoto Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
Macroscopic vascular invasion (MVI) is a critical independent factor associated with poor prognosis of patients with hepatocellular carcinoma (HCC). Nowadays, molecular-targeted agents (MTAs) are the standard treatment for advanced HCC as the worldwide treatment guidelines recommend. Various MTAs, such as sorafenib, regorafenib, lenvatinib and immune-checkpoint inhibitor are approved in the world, which means that now we are in the era of MTA-diversity. Although the approved MTAs prolong survival even for patients with advanced HCC, their therapeutic effects are unsatisfactory. Therefore, further progress is needed in treatment for advanced HCC. Hepatic arterial infusion chemotherapy (HAIC) is a promising treatment in treatment of HCC with MVI. HAIC is a local treatment which directly and consecutively delivers anticancer drugs into HCC. HAIC is theoretically possible to increase local concentrations of anti-cancer drugs in the liver and reduces systemic adverse events due to anti-cancer drugs. Although HAIC is thought to be a promising therapeutic modality in treatment of HCC, it is not positioned as a standardized treatment in the world because of low evidenced treatment. Our facility has historically been conducting HAIC treatment and reported the usefulness of HAIC (Tanaka et al. Cancer 2002 1;95(3):588, Nagamatsu et al. Aliment Pharmacol Ther. 2010 32;(4):543, Iwamoto et al. Cancers 2021 5;13(4):646). We firstly reported the usefulness of a conventional HAIC regimen ‘low dose FP’ and now shifted to a novel HAIC regimen ‘New FP” . Low dose FP is a regimen which is consisted of cisplatin and 5-fluorouracil (5-FU). And New FP is a regimen which is consisted of a fine-powder cisplatin suspended with lipiodol and 5-FU. In this presentation, we updated the current status of HAIC and summarized the therapeutic outcomes of HAIC. This presentation aimed to clarify the positioning of HAIC in the era of MTA-diversity in treatment of advanced HCC.
