Advance Publications: Research Papers:
Transarterial embolization for hepatocellular adenomas: a literature review
Bao-Hong Yuan1, Ru-Hong Li1, Bhavesh-K. Ahir2, Wei-Ping Yuan3, Jian-Hong Gu4,5, Tian Yang6 and Liang Ma3
1 Department of General Surgery, Yan’An Hospital Affiliated to Kunming Medical University, Kunming, China
2 Department of Medicine, Section of Hematology and Oncology, University of Illinois at Chicago, Chicago, IL, USA
3 Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
4 College of Veterinary Medicine, Yangzhou University, Yangzhou, China
5 Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, China
6 Department of Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
* These authors have contributed equally to this work
Correspondence to:
Tian Yang, email:
Liang Ma, email:
Keywords: avoidance of resection, hepatocellular adenomas, systematic review, transarterial embolization, tumor reduction
Received: January 04, 2017 Accepted: February 08, 2017 Published: March 11, 2017
Abstract
Since the utilization of transarterial embolization (TAE) for hepatocellular carcinoma, TAE is used to treat bleeding hepatocellular adenomas (HCAs) and occasionally, in symptomatic HCAs with large tumors. However, the role of TAE in an elective setting is uncertain. The present review aims to evaluate the benefits and harms of TAE in bleeding and non-bleeding HCAs, especially in an elective setting. A systematic review of studies published from January 2000 to December 2016 in the EMBASE, PubMed and Scopus databases was performed. Avoidance of resection and tumor reduction after TAE were the primary outcomes measure in both bleeding and non-bleeding HCAs. Twenty-one case series involving 1481 patients with HCAs were included in the analysis. Most of them were underwent hepatic resection. Only 148 (10%) patients (involving 189 lesions) received TAE, including 93 (62.8%) patients with bleeding HCAs and 55 (37.2%) patients with non-bleeding HCAs. Based on data of 107 tumors, the rates of Complete Response and Partial Response were 10.3% and 73.8%, respectively. Hepatic resection was avoided in 72 of 148 (48.6%) TAE treated patients. Intended elective TAE was performed in 45/148 (30.4%) patients; 95.6% of them did not require further hepatic resection. No mortality or adverse side effects were reported during the hospitalization period. Therefore, Either in an elective setting or in the setting of bleeding, TAE can be considered safe in the management of HCAs. In the elective setting, TAE can be regarded as a reasonable alternative management to hepatic resection. High-quality prospective study with long-term follow-up is warranted.