Ko Kadowaki, Shin Nishimura, Akihiro Toyoda, Ryuhei Yamamoto
Post-TAE tumor response was classified as partial response in 9 of 18 (50.0%), stable disease in 6 of 18 (33.3%), and progressive disease in 1 of 18 (5.6%). Two dogs (11.1%) died within 2 weeks after TAE. The median percentage of change in tumor volume, excluding those 2 dogs, was -32.6%. Extrahepatic collateral arterial supplies to tumors were identified in 13 of 18 (72.2%), including the gastroepiploic (22.2%), right phrenic (22.2%), left phrenic (27.8%), pancreatic (16.7%), and mesenteric (5.6%) arteries. Collateral supply from 2 and 3 vessels was observed in 3 of 18 (16.7%) and 1 of 18 (5.6%), respectively; second TAE was performed in 2 of 18 (11.1%) and hepatic lobectomy after TAE in 4 of 18 (22.2%) cases. Postoperative complications included mild diarrhea (77.8%), anorexia (61.1%), mild anemia (16.7%), and acute gallbladder infarction (11.1%) etc. Both cases of gallbladder infarction were asymptomatic with good clinical outcomes. Median survival time was 447 days, including all 18 dogs. Transcatheter arterial embolization achieved disease control in most dogs and often involved extrahepatic collaterals.
OBJECTIVE: To report tumor response, complications, outcomes, and extrahepatic collateral arterial supply presence in dogs with massive hepatocellular carcinoma (HCC) treated with transcatheter arterial embolization (TAE).
ANIMALS: 18 dogs diagnosed with massive HCC.
CLINICAL PRESENTATION: All dogs underwent contrast-enhanced CT and pretreatment histopathologic confirmation by laparoscopic biopsy (n = 1) or ultrasound-guided needle core biopsy (17). Tumor response was assessed using percentage of change in tumor volume on CT before TAE and 1 to 3 months after TAE.
RESULTS: Post-TAE tumor response was classified as partial response in 9 of 18 (50.0%), stable disease in 6 of 18 (33.3%), and progressive disease in 1 of 18 (5.6%). Two dogs (11.1%) died within 2 weeks after TAE. The median percentage of change in tumor volume, excluding those 2 dogs, was -32.6%. Extrahepatic collateral arterial supplies to tumors were identified in 13 of 18 (72.2%), including the gastroepiploic (22.2%), right phrenic (22.2%), left phrenic (27.8%), pancreatic (16.7%), and mesenteric (5.6%) arteries. Collateral supply from 2 and 3 vessels was observed in 3 of 18 (16.7%) and 1 of 18 (5.6%), respectively; second TAE was performed in 2 of 18 (11.1%) and hepatic lobectomy after TAE in 4 of 18 (22.2%) cases. Postoperative complications included mild diarrhea (77.8%), anorexia (61.1%), mild anemia (16.7%), and acute gallbladder infarction (11.1%) etc. Both cases of gallbladder infarction were asymptomatic with good clinical outcomes. Median survival time was 447 days, including all 18 dogs. Transcatheter arterial embolization achieved disease control in most dogs and often involved extrahepatic collaterals.
CLINICAL RELEVANCE: TAE may be a useful option in selected dogs with massive HCC.