Chemoembolization for hepatocellular carcinoma fed by right internal thoracic artery

Area of Science:

• Interventional Radiology
• Hepatobiliary Oncology
• Medical Imaging

Background:

• Hepatocellular carcinoma (HCC) is a primary liver malignancy with limited treatment options for unresectable cases.
• Transarterial chemoembolization (TACE) is a standard treatment for HCC, but access to hepatic arteries can be challenging.
• The right internal thoracic artery (RITA) offers an alternative route for TACE in specific HCC presentations.

Purpose of the Study:

• To evaluate the efficacy and safety of TACE performed via the RITA in patients with unresectable HCC.
• To assess technical success rates, tumor response, and survival outcomes following RITA-TACE.

Main Methods:

• A retrospective study of 21 patients with unresectable HCC who underwent TACE via RITA between January 2000 and June 2016.
• Evaluation of technical success, changes in serum alpha-fetoprotein (AFP), complications, disease control, and survival.
• Tumor characteristics, including location and size, and feeding artery supply were analyzed.

Main Results:

• 100% technical success rate for RITA-TACE.
• Significant reduction in serum AFP levels 1 month post-treatment (P < .01).
• 100% disease control rate at 3 months, with a median overall survival of 18.2 months and 1-year survival of 76.2%.

Conclusions:

• TACE via the RITA is a technically successful and safe approach for unresectable HCC.
• This technique demonstrates promising disease control and survival benefits.
• RITA-TACE can enhance therapeutic efficacy and reduce residual HCC, particularly for tumors adjacent to the diaphragm or with specific feeding patterns.