John Libbey Eurotext

Sang Thrombose Vaisseaux

Transarterial chemoembolization for hepatocellular carninoma: state of the art Volume 29, issue 5, September-October 2017

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Authors
1 Hôpital privé d’Antony, Centre d’imagerie diagnostique et interventionnelle La Providence, 25, avenue de La Providence, 92160 Antony, France
2 Clinique Arnault Tzanck, 122, avenue Maurice Donat, 06250 Mougins, France
3 IMFM, 5, rue Faidherbe, 75011 Paris, France
* Tirés à part
  • Key words: cirrhosis, hepatocellular carcinoma, intermediate stage, Barcelona-Clinic Liver Cancer algorithm, chimioembolization, doxorubicin, drug-eluting beads
  • DOI : 10.1684/stv.2017.0994
  • Page(s) : 187-94
  • Published in: 2017

Hepatocellular carcinoma occurs in 80% of cases in patients with chronic liver disease at cirrhosis stage, for which a semi-annual screening by hepatic ultrasonography is recommended. The therapeutic management of patients with hepatocellular carcinoma is well codified and must follow the Barcelona-Clinic Liver Cancer treatment algorithm. Chemoembolization is the reference treatment for patients at the “intermediate” stage (B) of the disease. The principle of chemoembolization is to inject intra-arterial antitumor chemotherapy with a vector and then to embolize the arteries feeding the tumors. Two techniques, conventional or with loaded beads, can be used, although neither has demonstrated greater clinical benefit than the other. The main contraindications are impaired hepatic function (Child-Pugh ≥8), reverse portal flow and renal insufficiency. Efficacy and safety are satisfactory despite a poor prognosis of the disease (