Exploratory study of microparticle transcatheter arterial chemoembolization combined with resection for huge hepatocellular carcinoma.

Objective: To investigate the safety and clinical efficacy of microparticle transcatheter arterial chemoembolization (mTACE) combined with surgical resection for the treatment of huge hepatocellular carcinoma (hHCC; ≥ 10 ​cm). Methods: A retrospective descriptive study was conducted to gather the clinical data of nine patients with hHCCs treated with mTACE combined with resection in Beijing Tsinghua Changgung Hospital from December 2016 to July 2020. The outcome were as follows: (1) the excellent effect and adverse reactions of mTACE and (2) the efficacy and safety of perioperative resection. Count data were expressed as absolute numbers and percentages. The measurement data of the normal distribution is represented by X ​± ​S, and the measurement data of the skewed distribution are represented by M (range). A paired t-test was used to compare the data of the same patient. p values <0.05 are considered statistically significant. Results: (1) Regarding the efficacy and safety of mTACE, all nine hHCCs were treated with mTACE one time. The tumor necrosis rate after particle TACE was (77.6 ​± ​15.7)% (51.7%-100%); according to the modified response evaluation criteria in solid tumors, the objective response was partial response in eight patients and complete response in one patient. The alpha fetoprotein (AFP) level was abnormal in six cases (>20 ​ng/mL), of which three cases exceeded the maximum value (>30,000 ​ng/mL) pre-mTACE. In six patients with abnormal AFP levels, the AFP level decreased in five patients, with a median percentage of 74.5% (35.2%-96.0%). The PIVKA-II level in nine patients was > 40 ​mAU/mL before mTACE and decreased to varying degrees after mTACE. The median percentage of decline was 76.0% (4.5%-99.8%). The maximum diameter of the tumor decreased from (13.9 ​± ​1.9) cm (11.0-16.4 ​cm) to (12.8 ± 1.9) ​cm (10.4-15.6 ​cm) ( Conclusions: mTACE combined with tumor resection is feasible for the treatment of patients with hHCC, which needs to be further confirmed by prospective studies.