ArticleJournal of gastrointestinal oncology2026
Partial splenic embolization plus antitumor therapy for treating patients with hepatocellular carcinoma and splenomegaly: a case series study.
Article in Journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hepatocellular carcinoma (HCC) is a significant global health challenge and is frequently complicated by splenomegaly and consequent thrombocytopenia, which adversely impact survival outcomes. Although partial splenic embolization (PSE) combined with transarterial chemoembolization (TACE) has demonstrated clinical benefits, its integration with contemporary systemic therapies, including tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), remains largely unexplored. This case series aims to present the platelet elevation and survival outcomes in HCC patients with splenomegaly who underwent PSE while receiving various antitumor treatment regimens. Case Description: This study included patients with clinically or pathologically diagnosed HCC and splenomegaly (spleen diameter ≥13 cm) who underwent PSE between January 2020 and February 2025. Participants received at least one antitumor intervention, such as with TACE, radiofrequency ablation (RFA), hepatic arterial infusion chemotherapy (HAIC), TKIs, or ICIs. Outcomes included platelet response rate (PRR) at ≥7 days and at 3-6 days post-PSE, duration of thrombocytopenia remission, and progression-free survival (PFS). A total of 50 patients were included in this study. The PRR at ≥7 days post-PSE varied between 33.33% and 100% among patients receiving different treatment strategies. The median duration of thrombocytopenia remission exceeded 10 months in all cases and ranged from 10.0 to 28.5 months. The median PFS varied from 4.5 to 21.0 months. The most frequent complication was splenic region pain, occurring from 25% to 100% of cases depending on the treatment, and no PSE-related mortality was observed. Conclusions: PSE combined with interventional and/or systemic therapy shows modest efficacy and a favorable safety profile in patients with HCC and splenomegaly. This approach may reduce the need for prolonged thrombopoietin agonist use and can be conveniently performed concurrently with TACE. Further validation through larger randomized controlled trials is recommended.
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