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Acupoint stimulation for pain management in patients after transcatheter arterial chemoembolization: A systematic review and meta-analysis 认领 引用
1
作者 Wen-yi WANG Xiao-min QUAN +4 位作者 Ze-yu HE Hong-yang CHEN Xun LI Guan-hu YANG Chao AN 《World Journal of Acupuncture-Moxibustion》 CAS CSCD 2026年第1期29-43,共15页
Objective:To systematically evaluate the clinical efficacy of acupoint stimulation for managing posttranscatheter arterial chemoembolization(TACE) pain and to provide a reliable evidence-based foundation for its clini... Objective:To systematically evaluate the clinical efficacy of acupoint stimulation for managing posttranscatheter arterial chemoembolization(TACE) pain and to provide a reliable evidence-based foundation for its clinical application in post-TACE pain management.Methods:Clinical randomized controlled trials evaluating acupoint stimulation for post-TACE pain were retrieved from the Chinese National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP Chinese Science and Technology Journal Database,China Biology Medicine disc,PubMed,Embase,Web of Science,the Cochrane Library,and ClinicalTrials.gov,covering all records from database inception to July 28,2025.Articles were screened and data were extracted according to predefined inclusion and exclusion criteria.The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Assessment Tool.Statistical analyses were conducted using Review Manager 5.4.1and Stata 15.0.The certainty of evidence for each outcome was evaluated using the Grading of Recommendations Assessment,Development,and Evaluation approach.This study was registered on PROSPERO(CRD420251108966).Results:A total of 17 studies involving 1525 patients with liver cancer who experienced acute postoperative pain following TACE were included.Meta-analysis results demonstrated that acupoint stimulation significantly reduced pain intensity scores(Numerical rating scale:mean difference [MD]=-0.83,95 %confidence interval [CI] [-0.96,-0.71], P <0.00001;Visual analog scale:MD=-1.15,95 % CI [-1.67,-0.63],P <0.0001),increased the complete pain remission rate(Risk ratio [RR]=1.74,95% CI [1.35,2.23],P <0.0001),shortened the onset time of analgesia(MD=-25.39 min,95 % CI [-27.53,-23.26],P <0.00001),prolonged the duration of analgesia(MD=3.03 h,95% CI [0.40,5.66],P=0.02),and reduced the need for rescue analgesics(RR=0.43,95% CI [0.28,0.64],P <0.0001).Furthermore,acupoint stimulation improved liver function indicators(Alanine aminotransferase:MD=-5.27 U/L,95%CI [-6.90,-3.63],P <0.00001;Aspartate aminotransferase:MD=-6.76 U/L,95 % CI [-8.39,-5.12],P <0.00001),lowered plasma substance P levels(MD=-18.28 ng/L,95% CI [-30.97,-5.60],P=0.005),and enhanced patient satisfaction(RR=1.33,95% CI [1.05,1.69],P=0.02).Regarding safety,acupoint stimulation significantly reduced the risk of adverse events compared with blank controls(RR=0.24,95% CI [0.10,0.56],P=0.001).However,no statistically significant differences in the risk of adverse events were observed when acupoint stimulation was combined with analgesics(RR=0.91,95 % CI [0.39,2.13],P=0.82) or compared directly to analgesics alone(RR=0.79,95% CI [0.04,14.95],P=0.87).Conclusion:Acupoint stimulation demonstrates favorable effects in alleviating pain following TACE.However,the relatively low methodological quality of the included studies limits the strength of the conclusions.Additional high-quality studies are needed to provide more robust evidence to guide clinical practice. 展开更多
关键词 Acupoint stimulation Transcatheter arterial chemoembolization Postoperative pain Liver cancer Meta-analysis
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Expression of LHFPL2 in hepatocellular carcinoma and itsassociation with prognosis after transarterial chemoembolization 认领 引用
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作者 Lei Sun Kang Chen Xiao-Li Zhu 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第6期179-186,共8页
BACKGROUND Transarterial chemoembolization(TACE)is a standard treatment for recurrent hepatocellular carcinoma(HCC)after liver resection.However,resistance to TACE considerably limits its efficacy and worsens patient ... BACKGROUND Transarterial chemoembolization(TACE)is a standard treatment for recurrent hepatocellular carcinoma(HCC)after liver resection.However,resistance to TACE considerably limits its efficacy and worsens patient prognosis.Identifying molecular markers that predict TACE response is crucial for individualized treatment strategies.AIM To investigate lipoma HMGIC fusion partner-like 2(LHFPL2)expression in patients with HCC and its association with TACE efficacy and overall survival(OS).METHODS A retrospective study was conducted including 60 patients with HCC who underwent≥3 standardized TACE treatments for recurrence after curative hepatectomy between January 2014 and December 2020 at Jiangsu Provincial People’s Hospital and Wuxi People’s Hospital.The patients were divided into TACE-resistant(n=30)and non-resistant(n=30)groups.LHFPL2 protein expression in tumor tissues was assessed using immunohistochemistry,and its association with clinicopathological features,TACE response,and OS was analyzed.The Kaplan-Meier method,log-rank test,and Cox regression models were used to evaluate prognostic value.RESULTS The TACE-resistant group exhibited significantly higher LHFPL2 expression than the non-resistant group(P<0.05).Significant differences were observed between the two groups in hepatitis B virus carrier status,alphafetoprotein(AFP)levels,tumor differentiation,and LHFPL2 expression(P<0.05).The median OS in the LHFPL2 high-expression group was 2.28 years,which was significantly shorter than that in the low expression group(P<0.05).Multivariate Cox regression analysis indicated that high LHFPL2 expression,AFP≥400 ng/mL,and TACE resistance were independent risk factors for OS(P<0.05).A combined prognostic model using LHFPL2 and AFP revealed that patients with high LHFPL2 and AFP≥400 ng/mL had the poorest prognosis(median OS 1.44 years),whereas patients with low LHFPL2 and AFP<400 ng/mL had the best prognosis(median OS not reached),with significant differences(P<0.05).CONCLUSION High LHFPL2 expression was closely associated with TACE resistance and was an independent predictor of poor prognosis in patients with HCC.Combining LHFPL2 with AFP enhanced prognostic stratification,providing a novel molecular marker and clinical basis for personalized therapy and TACE response prediction. 展开更多
关键词 Hepatocellular carcinoma Lipoma HMGIC fusion partner-like 2 Transarterial chemoembolization Transarterial chemoembolization resistance Prognosis Alpha-fetoprotein
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Transcatheter arterial chemoembolization plus lenvatinib toward precision prognostication for unresectable hepatocellular carcinoma 认领 引用
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作者 Yu-Han Yang 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第6期9-15,共7页
A recent study presented a timely prognostic model deriving from a metaanalysis of 43 group studies and externally validated with clinical data for predicting overall survival and progression-free survival in patients... A recent study presented a timely prognostic model deriving from a metaanalysis of 43 group studies and externally validated with clinical data for predicting overall survival and progression-free survival in patients with unresectable hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus lenvatinib.The model integrated nine readily available clinical variables,including number of tumors,microvascular invasion,Eastern Cooperative Oncology Group grade,Child-Pugh stage,triple therapy with programmed death 1 inhibitors,Barcelona Clinic Liver Cancer stage,extrahepatic metastasis,alpha-fetoproteinlevel,and hepatitis B virus(HBV)status,and demonstrated favorable discrimination relative to Barcelona Clinic Liver Cancer staging.This article acknowledges that the underlying evidence base is predominantly observational and derived largely from HBV-endemic regions;therefore,prospective and geographically diverse validation is required before broad clinical implementation.This article acknowledges the study’s strengths concerning large evidence synthesis,external validation,and clinical applicability while offering constructive critique on methodology,potential biases,biologic interpretation,and steps to maximize translational impact.More priorities could be proposed for refining and prospectively validating the model,integrating molecular and imaging biomarkers,addressing heterogeneity from HBV-endemic populations,and designing interventional studies to test model-guided therapy.Future work should test the model in prospective,multiethnic cohorts,examine interactions with etiologic subtypes(HBV/hepatitis C viruson-alcoholic steatohepatitis),and integrate temporally aware analyses and biomarker/imaging data to optimize individualized treatment selection.These measures would strengthen the model’s role as a decision-support tool and accelerate evidence-based personalized care in advanced unresectable hepatocellular carcinoma. 展开更多
关键词 Hepatocellular carcinoma Transcatheter arterial chemoembolization Lenvatinib Prognostic model Nomogram Survival prediction
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Influencing factors for digital subtraction angiography and conebeam computed tomography guided bead chemoembolization in resistant liver cancer 认领 引用
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作者 Jun Liu Yi Lu +2 位作者 Guo-Wen Yin Qing-Yu Xu You Lu 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第4期176-183,共8页
BACKGROUND Transcatheter arterial chemoembolization(TACE)failure or refractoriness in hepatocellular carcinoma(HCC)refers to patients who continue to experience tumor progression or recurrence after TACE.Drug-eluting ... BACKGROUND Transcatheter arterial chemoembolization(TACE)failure or refractoriness in hepatocellular carcinoma(HCC)refers to patients who continue to experience tumor progression or recurrence after TACE.Drug-eluting bead(DEB)TACE guided by digital subtraction angiography(DSA)is a novel interventional technique.However,the efficacy of DEB-TACE varies among patients,making the analysis of the factors influencing treatment outcomes clinically important for optimizing therapeutic strategies and improving prognosis.AIM To explore the factors influencing the clinical efficacy of DSA-guided DEB-TACE in the treatment of TACE failureefractoriness in patients with HCC.METHODS A retrospective analysis was conducted in 96 patients with HCC who were admitted to our hospital between January 2021 and December 2023,met the criteria for TACE failure or refractoriness,and underwent real-time DSA-guided DEB-TACE.Based on the modified response evaluation criteria in solid tumors criteria assessed at the 1-year follow-up,patients were classified into a favorableoutcome group(complete or partial response)and a poor-outcome group(stable or progressive disease).The clinical data of the two groups were compared,and multivariate logistic regression analysis was conducted to identify independent factors affecting treatment outcomes.RESULTS Among 96 patients with HCC and TACE failureefractoriness,64 had favorable outcomes,whereas 32 had poor outcomes.Univariate analysis revealed that the two groups exhibited statistically significant differences(P<0.05)in lesion diameter≥5 cm,multiple lesions,Child-Pugh class B,and preoperative alpha-fetoprotein(AFP)level≥400 ng/mL.Multivariate logistic regression analysis identified lesion diameter,multiple lesions,Child-Pugh classification,and preoperative AFP levels as independent risk factors for poor outcomes in patients with HCC and TACE failure or refractoriness(P<0.05).CONCLUSION The efficacy of DSA-guided DEB-TACE in patients with TACE-refractory HCC is closely linked to lesion diameter,multiplicity,Child-Pugh class,and preoperative AFP levels. 展开更多
关键词 Digital subtraction angiography-guided procedure Drug-eluting bead transcatheter arterial chemoembolization Transcatheter arterial chemoembolization failureefractoriness Hepatocellular carcinoma Influencing factors
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Habitat imaging on contrast-enhanced magnetic resonance imaging predicts early response to transarterial chemoembolization in hepatocellular carcinoma 认领 引用
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作者 Jun-Bo Lv Wei Liu +4 位作者 Yu-Guo Wei Hui-Na Tang Qing-Qing Chen Hong-Jie Hu Ji-Bo Hu 《World Journal of Gastroenterology》 SCIE CAS 2026年第15期46-60,共15页
BACKGROUND Transcatheter arterial chemoembolization(TACE)is a core treatment for hepatocellular carcinoma(HCC),but significant variability in therapeutic responses exists due to intratumoral heterogeneity(ITH).Convent... BACKGROUND Transcatheter arterial chemoembolization(TACE)is a core treatment for hepatocellular carcinoma(HCC),but significant variability in therapeutic responses exists due to intratumoral heterogeneity(ITH).Conventional predictive methods ignore subregional tumor heterogeneity,limiting their accuracy and generalizability.Habitat imaging enables non-invasive quantification of ITH by characterizing tumor subregional diversity,yet few studies have integrated this technique with clinical and radiomic features to enhance TACE response prediction.AIM To develop and validate a combined model integrating clinical,radiomics,and ITH features for predicting early response to TACE in HCC patients.METHODS A total of 223 HCC patients were divided into training(n=107),internal validation(n=46),and external validation(n=70)cohorts.Preoperative magnetic resonance imaging images were processed via simple linear iterative clustering superpixel segmentation and Gaussian mixture model clustering(Bayesian information criterion-optimized)to quantify tumor ecological diversity.The ITH and radiomic features were extracted and selected by recursive feature elimination with crossvalidation.A combined model was constructed and evaluated using receiver operating characteristic curves,calibration curves,and decision curve analysis.We employed SHapley Additive exPlanations analysis to quantify the contributions of each feature to the combined model.RESULTS The combined model achieved the highest area under the curve(AUC)of 0.97(95%confidence interval:0.93-0.99)in the training set,outperforming clinical(AUC=0.86)and radiomics(AUC=0.71)models.It maintained robust performance in internal(AUC=0.91)and external(AUC=0.93)validation cohorts,with good calibration and superior clinical net benefit in decision curve analysis.CONCLUSION Integrating ITH features significantly enhances the prediction of TACE response in HCC.The combined model exhibits excellent discriminative power and generalizability,fulfilling the objective of providing a reliable tool for personalized treatment decision-making. 展开更多
关键词 Hepatocellular carcinoma Transcatheter arterial chemoembolization Intratumoral heterogeneity Habitat imaging Magnetic resonance imaging
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Acute liver injury after transcatheter arterial chemoembolization in patients with hepatitis B virus-related intermediate or advanced hepatocellular carcinoma stages 认领 引用
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作者 Xin-Hui Jie De-Yang Xi +1 位作者 Shuang-Shuang Zhang Xue-Bing Yan 《World Journal of Gastroenterology》 SCIE CAS 2026年第24期71-81,共11页
BACKGROUND Acute liver injury(ALI)is a prevalent complication following transcatheter arterial chemoembolization(TACE),a procedure frequently used in patients with hepatitis B virus(HBV)-related hepatocellular carcino... BACKGROUND Acute liver injury(ALI)is a prevalent complication following transcatheter arterial chemoembolization(TACE),a procedure frequently used in patients with hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC).This complication may break the treatment schedule and have a negative influence on the clinical outcomes.AIM To determine the risk factors for post-TACE ALI and establish nomogram for personalized prediction in patients with HBV-related intermediate-to-advanced HCC.METHODS This retrospective study encompassed 172 patients with HBV-related intermediate to advanced HCC who underwent TACE from January 2019 to December 2024.Patients were categorized into ALI and non-ALI groups.Clinical data were collected within one week before and after TACE.A predictive nomogram was constructed based on independent risk factors identified by multivariate logistic regression.The discriminative ability,calibration,and clinical net benefit of this model were validated using receiver operating characteristic curves(area under the curve),calibration curves,and decision curve analysis.RESULTS The retrospective study was based on clinical and laboratory data from 172 patients with a clinical diagnosis of HBV-related HCC and who received TACE treatment.Of these,62 patients(36.0%)developed ALI.Multivariate analysis revealed Child-Pugh stage(A vs B/C),number of TACE treatments,and HBV DNA levels(≥20 IU/mL)as independent predictors of ALI(P<0.05).A nomogram incorporating these variables was developed to facilitate individualized risk assessment.CONCLUSION Child-Pugh stage,number of TACE treatments,and HBV DNA load are significant predictors of ALI following TACE in patients with HBV-related intermediate or advanced HCC.By integrating these variables,the proposed nomogram provides a practical tool for individualized risk assessment and may assist in perioperative management and treatment planning.External validation through multicenter prospective studies is warranted. 展开更多
关键词 Acute liver injury Transcatheter arterial chemoembolization Hepatitis B virus Hepatocellular carcinoma Risk factors Nomogram
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Arterial and biliary complications after transarterial chemoembolization for hepatocellular carcinoma 认领 引用
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作者 Yan-Xin Wan Zhen-Yi Lin +3 位作者 Lin-Tao Chen Rong-Qian Wu Yu Zhang Zhao-Qing Du 《World Journal of Clinical Oncology》 2026年第1期74-92,共19页
Transarterial chemoembolization is a common treatment modality that significantly improves prognosis in patients with intermediate-advanced hepatocellular carcinoma.However,this procedure is associated with a spectrum... Transarterial chemoembolization is a common treatment modality that significantly improves prognosis in patients with intermediate-advanced hepatocellular carcinoma.However,this procedure is associated with a spectrum of potential arterial and biliary complications,ranging from mild self-limiting ones to those severely affecting patient outcomes.This review systematically integrates recent studies to explore the epidemiological characteristics,risk factors,and management strategies of these two groups of complications.Arterial complications,primarily hepatic artery stenosis,pseudoaneurysm,and arterial rupture hemorrhage,exhibit a biphasic distribution pattern with the majority occurring within 72 hours postoperatively,while a notable portion occurs within 1-4 weeks.Biliary complications,including biliary fistulas,biliary strictures,and ischemic cholangitis,exhibit higher incidence rates and more insidious clinical manifestations than arterial complications.Risk factors include the severity of cirrhosis,tumor location,procedural technique,and chemotherapeutic drug toxicity.Management strategies emphasize careful preoperative planning(primarily with computed tomography angiography),standardized intraoperative procedures(like superselective embolization),and multi-pronged postoperative monitoring(imaging combined with laboratory indicators of liver function).Interventional embolization or surgical reconstruction is used for arterial complications,while endoscopic therapy or surgical drainage is selected based on the severity of injury for biliary complications.Future research should further explore individualized treatment regimens and novel embolic materials to reduce complication rates and enhance the safety of transarterial chemoembolization. 展开更多
关键词 Hepatocellular carcinoma Transarterial chemoembolization Arterial complications Biliary complications Management strategies
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Interpretable radiomics model based on magnetic resonance imaging to predict responses to transarterial chemoembolization for hepatocellular carcinoma 认领 引用
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作者 Qi Mao Peng Zhang +5 位作者 Mao-Ting Zhou Yue Shi Xu-Li Min Hao Xu Lin Yang Xiao-Ming Zhang 《World Journal of Radiology》 2026年第2期37-50,共14页
BACKGROUND Transarterial chemoembolization(TACE)is important role for the treatment of unresectable hepatocellular carcinoma(HCC).However,owing to the heterogeneity of HCC tumors,TACE efficacy varies among individual ... BACKGROUND Transarterial chemoembolization(TACE)is important role for the treatment of unresectable hepatocellular carcinoma(HCC).However,owing to the heterogeneity of HCC tumors,TACE efficacy varies among individual HCC patients.Accurate preoperative prediction of responses to TACE among HCC patients could guide the development of individualized treatment strategies and improve patient outcomes.AIM To investigate the predictive value of multiple-sequence magnetic resonance imaging(MRI)radiomic features combined with clinical indices for the response to TACE among HCC patients and to develop an interpretable machine learning model.METHODS A total of 116 patients with HCC who underwent TACE were retrospectively enrolled.Patients in this study were randomly divided into a training group and a validation group at a ratio of 7:3.The response to TACE was evaluated according to the modified Response Evaluation Criteria in Solid Tumors.Radiomic features were extracted from axial fatsuppressed T2-weighted imaging,arterial phase and portal venous phase axial dynamic contrast-enhanced MRI sequences.The least absolute shrinkage and selection operator method was used to select the best radiomic features.Univariate and multivariate logistic regression were used to select clinical predictive factors that affect the response to TACE among patients with HCC.Logistic regression was used to construct a radiomic model of each sequence,a multiple-sequence MRI radiomics model,and a radiomic-clinical(RC)model.The predictive performance of each model was evaluated using the area under the receiver operating characteristic curve.The risk factors in the RC model were subsequently interpreted via SHapley Additive exPlanations analysis.RESULTS The area under the receiver operating characteristic curve values of the fat-suppressed T2-weighted imaging,arterial-phase,portal-venous-phase,joint-radiomic model and RC model were 0.771,0.668,0.725,0.845 and 0.929,respectively,in the training group and 0.705,0.666,0.675,0.799 and 0.815,respectively,in the validation group.The clinical-radiomic model had the best predictive performance.The SHapley Additive exPlanations algorithm was used to illustrate the contribution of each feature in the RC model.CONCLUSION The interpretable RC model could successfully stratify HCC patients into TACE responders and TACE nonresponders and serve as a potential tool to identify more appropriate HCC patients for TACE,thus sparing patients from receiving ineffective and unnecessary treatments. 展开更多
关键词 Magnetic resonance imaging Radiomics Hepatocellular carcinoma Transarterial chemoembolization Treatment response
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Assessing predictive value of contrast-enhanced ultrasound combined with doppler ultrasound for post-transcatheter arterial chemoembolization prognosis in hepatocellular carcinoma 认领 引用
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作者 Jia-Jiao Qian Min Xu Yan-Song Ji 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期266-273,共8页
BACKGROUND Hepatocellular carcinoma(HCC)is a significant global health issue that is often diagnosed in advanced stages.Transcatheter arterial chemoembolization(TACE)is a standard intervention for unresectable HCC;how... BACKGROUND Hepatocellular carcinoma(HCC)is a significant global health issue that is often diagnosed in advanced stages.Transcatheter arterial chemoembolization(TACE)is a standard intervention for unresectable HCC;however,it is frequently followed by tumor recurrence,highlighting the need for reliable prognostic tools.This study evaluated the combined predictive value of contrast-enhanced ultrasound(CEUS)and Doppler ultrasound in assessing the clinical outcomes post-TACE.AIM To develop a comprehensive imaging strategy that can guide personalized treatment planning through an improved assessment of tumor vascularization and liver function,assess the predictive value of CEUS combined with Doppler ultrasound in patients with HCC who underwent TACE.METHODS This retrospective study analyzed 124 patients with HCC who underwent TACE.Based on 1-year outcomes,the patients were stratified into good(n=86)and poor(n=38)prognostic groups.We compared the clinical and ultrasound data(CEUS and Doppler parameters)between the groups to identify prognostic factors.Multivariate logistic regression was used to identify independent predictors,and receiver operating characteristic curve was used to evaluate the predictive power of the combined model for post-TACE prognosis.RESULTS Significant differences were observed between the two groups in terms of TNM stage,number of lesions,tumor size,arrival time(AT),washout time(WT),hepatic artery peak systolic velocity(VPs),portal vein velocity,and blood flow grading(P<0.05).Logistic regression analysis showed that TNM stage,tumor size,number of lesions,hepatic artery VPs,and blood flow grading were risk factors affecting the prognosis of patients with HCC following TACE,whereas AT,WT,and portal vein velocity were protective factors(P<0.05).Receiver operating characteristic curve analysis demonstrated that the area under the curve values for predicting post-TACE prognosis in patients with HCC were as follows:(1)0.704 for AT;(2)0.762 for WT;(3)0.796 for hepatic artery VPs;(4)0.796 for portal vein velocity;(5)0.657 for blood flow grading;and(6)0.942 for the combined model.CONCLUSION The combination of CEUS and Doppler ultrasound parameters,which reflect tumor vascularization and liver function,has high a predictive value for the prognosis of patients with HCC following TACE. 展开更多
关键词 Contrast-enhanced ultrasound Doppler ultrasound Hepatocellular carcinoma Transcatheter arterial chemoembolization Prognosis
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Impact of bundle care on quality of life and nutrition after transarterial chemoembolization 认领 引用
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作者 Gui-Yun Zhao Jie Yu 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第6期177-188,共12页
BACKGROUND The absence of standard postoperative protocols for patients with hepatocellular carcinoma(HCC)undergoing transarterial chemoembolization(TACE)may negatively affect health and quality of life(QoL).Bundle ca... BACKGROUND The absence of standard postoperative protocols for patients with hepatocellular carcinoma(HCC)undergoing transarterial chemoembolization(TACE)may negatively affect health and quality of life(QoL).Bundle care is a multidisciplinary,evidence-based model that offers a structured approach.Yet,its effects on this population remain underexplored.The hypothesis in this study was that the implementation of the bundle care protocol can improve QoL and nutritional status after TACE.AIM To examine the effects of a multidisciplinary bundle care protocol on the QoL and nutritional status of post-TACE HCC patients.METHODS A tertiary hospital conducted a retrospective study on 80 HCC patients who underwent TACE from June 2023 to January 2025.They were included in the routine care group(control group;n=40),routine care and bundle care group(intervention group;n=40).The bundle care protocol included multidisciplinary coordination,dynamic assessments[Patient-Generated Subjective Global Assessment(PG-SGA),Hospital Anxiety and Depression Scale(HADS),Numerical Rating Scale],stepwise analgesia,stratified nutrition support,and intelligent follow-up with WeChat.The nutritional status(PG-SGA),psychological scores(HADS),post-embolization symptoms,and laboratory parameters were outcome measures.Independent t-tests,χ2 tests and non-parametric tests were used to analyze data.RESULTS Post-intervention,the bundle care group showed significantly lower PG-SGA scores than the control group(1.86±0.89 vs 4.46±2.13,P<0.001),lower anxiety(HADS-Anxiety:0.36±0.49 vs 4.25±2.03,P<0.001)and depression scores(HADS-Depression:0.00 vs 5.00,P<0.001).Albumin levels(38.33±4.09 g/L vs 35.60±4.87 g/L,P=0.008)and body mass index(24.24±2.45 vs 21.67±2.63,P<0.001)were significantly higher in the bundle care group.Nausea resolution was 97.5%in the bundle care group vs 87.5%in controls(P<0.05).CONCLUSION In patients with HCC after TACE,bundle care can significantly improve nutritional status,psychological status,and symptom control to make a case for further clinical use. 展开更多
关键词 Bundle care Transarterial chemoembolization Hepatocellular carcinoma Nutritional status Quality of life
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Synchronous vs sequential combination of transarterial chemoembolization and microwave ablation for hepatocellular carcinoma:Efficacy and prognosis 认领 引用
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作者 Yi Yu Wei Yuan +4 位作者 Jin Lei Chun-Bo Zhao Cheng-Gang Tao Sheng-Hui Liu Bai-Lin Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第2期339-346,共8页
BACKGROUND Despite therapeutic advances,outcomes in hepatocellular carcinoma(HCC)remain suboptimal,underscoring the need to explore more effective treatment strategies.AIM To compare efficacy and prognosis in HCC pati... BACKGROUND Despite therapeutic advances,outcomes in hepatocellular carcinoma(HCC)remain suboptimal,underscoring the need to explore more effective treatment strategies.AIM To compare efficacy and prognosis in HCC patients treated with synchronous vs sequential transcatheter arterial chemoembolization(TACE)and microwave ablation(MWA).METHODS A total of 106 patients with HCC admitted between March 2022 and March 2024 were included.Patients receiving concurrent TACE and MWA constituted the synchronous group(n=56),while those treated with TACE followed by MWA formed the sequential group(n=50).Intergroup comparisons encompassed curative efficacy,ablation-related parameters(number of needle insertions,ablation duration,and power),prognostic indicators(progression-free survival and overall survival),tumor biomarkers[alpha-fetoprotein(AFP),AFP-L3],hepatic function indices[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)],and post-procedural complications(pyrexia,abdominal pain,and gastrointestinal reactions).RESULTS No significant intergroup differences were observed in curative efficacy,ablation power,prognosis,or overall complication rates(P>0.05).However,the synchronous group required fewer ablation needles and shorter ablation durations than the sequential group(P0.05).CONCLUSION Synchronous TACE combined with MWA is non-inferior to the sequential approach regarding therapeutic efficacy,survival outcomes,safety,and tumor control in HCC.Notably,the synchronous strategy offers procedural advantages by reducing ablation attempts and shortening treatment duration. 展开更多
关键词 Transcatheter arterial chemoembolization Microwave ablation Synchronous Sequential Hepatocellular carcinoma Therapeutic effectiveness Outcome
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Clinical and radiomic characteristics of transarterial chemoembolization combined with immunotherapy in hepatocellular carcinoma 认领 引用
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作者 Qian Xia Wei Shan Hao Yan 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第7期193-201,共9页
BACKGROUND Hepatocellular carcinoma(HCC)is associated with a poor prognosis.Intermediate-to advanced-stage HCC patients are commonly administered transarterial chemoembolization(TACE).Recently,TACE combined with immun... BACKGROUND Hepatocellular carcinoma(HCC)is associated with a poor prognosis.Intermediate-to advanced-stage HCC patients are commonly administered transarterial chemoembolization(TACE).Recently,TACE combined with immunotherapy has emerged as a promising therapeutic strategy;however,there is substantial interindividual heterogeneity in treatment responses.Therefore,developing efficient predictive biomarkers for therapeutic success is essential for attaining individualized therapy.AIM To assess the short-term efficacy of TACE in conjunction with immunotherapy against TACE monotherapy in patients with intermediate-advanced HCC,while also preliminarily investigating the clinical,serological,and radiomic characteristics associated with the efficacy of the combination treatment.METHODS This retrospective study analyzed 120 intermediate-advanced HCC patients admitted to our hospital between January 2023 and January 2025.Of these patients,60 received TACE+immunotherapy(combined group),while 60 received TACE monotherapy(TACE group).The objective response rate,disease control rate at 3 months post-treatment,and changes in serum levels of tumor markers(α-Lfucosidase,alpha-fetoprotein,carbohydrate antigen 19-9),angiogenic factors(hepatocyte growth factor,vascular endothelial growth factor,platelet-derived growth factor,basic fibroblast growth factor),and apoptosis-related molecules(cysteine aspartic protease-3,survivin)before and after treatment were compared between the two groups.Based on the modified response evaluation criteria in solid tumors,the combination cohort was further stratified into responders(complete response/partial response)and non-responders(stable disease/progressive disease).The differences and correlations between baseline clinical characteristics and radiomic features(e.g.,entropy,gray-level variance,texture features)were acquired from pre-treatment computed tomography/magnetic resonance imaging scans.RESULTS The objective response rate(36.7%vs 23.3%)and disease control rate(76.7%vs 60.0%)in the combination group were substantially higher than those in the TACE group(both P<0.05).The combination group had superior efficacy in reducing serum tumor marker levels,suppressing angiogenic factors,upregulating cysteine aspartic protease-3 expression,and downregulating survivin expression relative to the TACE group(all P<0.05).Moreover,the combination group’s radiomic features(including gray-level co-occurrence matrix contrast,arterialphase entropy,and gray-level variance)were significantly correlated with clinical features,including tumor volume,number,and location(all P<0.05).However,there were no significant differences in baseline clinical characteristics between responders and non-responders.CONCLUSION TACE+immunotherapy indicated improved short-term efficacy and serological molecules modulation compared with TACE monotherapy in intermediate-advanced HCC patients.Radiomic features can quantitatively reflect tumor heterogeneity and correlate with basic tumor characteristics,indicating their potential as non-invasive biomarkers.However,the predictive value of these radiomic characteristics for the effectiveness of combination therapy necessitates more validation in prospective investigations. 展开更多
关键词 Hepatocellular carcinoma Transarterial chemoembolization Immunotherapy Therapeutic efficacy Radiomics Prediction
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Research Progress on Radiomics Combined Model for Predicting the Efficacy of Transcatheter Arterial Chemoembolization in Hepatocellular Carcinoma 认领 引用
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作者 Jiahao Sun Yixiong Zhang Jiaping Wang 《Proceedings of Anticancer Research》 2026年第2期100-106,共7页
Radiomics,a field that extracts quantitative features from medical images,plays a crucial role in predicting the efficacy of treatments like Transcatheter Arterial Chemoembolization(TACE)for hepatocellular carcinoma(H... Radiomics,a field that extracts quantitative features from medical images,plays a crucial role in predicting the efficacy of treatments like Transcatheter Arterial Chemoembolization(TACE)for hepatocellular carcinoma(HCC).Recent advancements have shown that combining radiomics with clinical and genetic data enhances predictive accuracy.This integration has significantly influenced current diagnostic and treatment strategies for HCC.Studies have demonstrated that these combined models provide more precise predictions,leading to improved patient outcomes.This review summarizes recent advances and current challenges in radiomics-based combined models for predicting outcomes after TACE in HCC.It systematically outlines key breakthroughs,including multimodal data fusion,improved methods for quantifying intratumoral heterogeneity,and enhanced model predictive performance.It also examines persistent bottlenecks:dataset-dependent feature standardization,limited model generalizability,clinical annotation bias,and high computational costs.The goal of this review was to guide researchers in addressing these technical barriers and optimizing model architectures,to provide evidence for individualized clinical decision-making,and to accelerate the translation of radiomics combined models from basic research into standardized clinical practice-ultimately improving post-TACE outcomes and long-term quality of life for HCC patients. 展开更多
关键词 Hepatocellular carcinoma Transcatheter Arterial Chemoembolization Radiomics combined model Efficacy prediction
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Nursing factors in patients with hepatocellular carcinoma after transarterial chemoembolization 认领 引用
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作者 Yan Zheng Fei-Yan Huang +2 位作者 Li-Xia Cai Chong Peng Tong-Yin Zhu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2025年第4期471-472,共2页
To the Editor:We read with great interest the recent article by Shi et al.pub-lished in Hepatobiliary Pancreatic Diseases International[1].Shi’s study was based on radiological features and clinical factors to constr... To the Editor:We read with great interest the recent article by Shi et al.pub-lished in Hepatobiliary Pancreatic Diseases International[1].Shi’s study was based on radiological features and clinical factors to construct a model to predict the effectiveness of first transarterial chemoembolization(TACE)treatment for hepatocellular carcinoma(HCC)in prolonging patient survival.The results showed that area under the receiver operating characteristic curve was 0.964 for the training cohort and 0.949 for the validation cohort. 展开更多
关键词 construct model predict effectiveness area receiver operating characteristic curve hepatocellular carcinoma hcc hepatobiliary pancreatic diseases hepatocellular carcinoma transarterial chemoembolization radiological features clinical factors transarterial chemoembolization tace treatment
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Tumor calcification and sustained complete response after chemoembolization in hepatocellular carcinoma:Two case reports and review of literature 认领 引用
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作者 Sultan R Alharbi 《World Journal of Gastrointestinal Oncology》 SCIE 2025年第12期313-323,共11页
BACKGROUND Transarterial chemoembolization(TACE)is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma(HCC).Although it is rarely curative,complete radiological response can be achi... BACKGROUND Transarterial chemoembolization(TACE)is a widely accepted palliative therapy modality for unresectable hepatocellular carcinoma(HCC).Although it is rarely curative,complete radiological response can be achieved in selected patients,leading to prolonged survival.Post-treatment tumoral calcification is an uncom-mon imaging finding in HCC and is rarely reported after drug-eluting beads TACE(DEB-TACE).CASE SUMMARY Two patients with large,solitary HCCs(>5 cm)were treated with DEB-TACE,and both achieved complete radiological response after two treatment sessions.Approximately 1 year after DEB-TACE,imaging demonstrated progressive peripheral tumoral calcification.Over 6 years of follow-up,both patients remained in remission with preserved liver function.CONCLUSION These two cases highlight the potential for complete remission and long-term survival in selected patients with large HCC following DEB-TACE.The appearance of peripheral calcification may represent a late imaging marker of effective tumor necrosis and durable treatment response although prospective studies are warranted to clarify its prognostic value. 展开更多
关键词 Hepatocellular carcinoma Transarterial chemoembolization Drug-eluting beads chemoembolization Complete response Remission Tumoral calcification Case report
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Adjuvant lenvatinib in combination with transarterial chemoembolization for hepatocellular carcinoma patients with high risk of postoperative recurrence:A multicenter prospective cohort study 认领 引用 被引量：5
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作者 Jin-Hong Chen Lu Lu +19 位作者 Xiao-Yun Zhang Bang-De Xiang Xiao Xu Xiang-Cheng Li Zhi-Yong Huang Tian-Fu Wen Liu-Ping Luo Jing Huang Jian-Hong Zhong Zhi-Kun Liu Chang-Xian Li Xin Long Wen-Wei Zhu Xin Yang Chao-Qun Wang Hu-Liang Jia Ju-Bo Zhang Yong-Yi Zeng Cai-De Lu Lun-Xiu Qin 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2025年第3期277-285,共9页
Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarte... Background:The high recurrent rate after surgery hinders the survival of patients with hepatocellular carcinoma(HCC).This prospective cohort study aimed to evaluate the efficacy and safety of lenvatinib plus transarterial chemoembolization(TACE)as an adjuvant therapy in HCC patients with high risk of recurrence.Methods:Patients were enrolled from eight hepatobiliary centers in China.The primary endpoint was disease-free survival(DFS).The secondary endpoints were overall survival(OS)and safety.Additionally,propensity score matching(PSM)and other three propensity score analyses were performed to balance the potential baseline bias to validate the conclusion.The adverse events(AEs)were recorded throughout the study.The study was registered at Clinical Trials.gov(NCT03838796).Results:A total of 297 patients were enrolled,with 147 in the LEN+TACE group and 150 in the TACE group.Before PSM,the LEN+TACE group achieved significantly better DFS than the TACE group(19.0 vs.10.0 months,P=0.011).PSM analysis identified 111 matched pairs.After PSM,the LEN+TACE group also showed better DFS(19.0 vs.9.0 months,P=0.018).Other three propensity score analyses yielded similar DFS benefit tendency.Furthermore,favorable OS was also obtained in the LEN+TACE group before PSM.Lenvatinib related AEs of grade 3 or 4 occurred in 28.6%of the patients in the LEN+TACE group.Conclusions:Adjuvant lenvatinib plus TACE might be a promising adjuvant approach for HCC patients with high risk of recurrence,which could significantly prolong DFS and potentially OS with a manageable safety profile. 展开更多
关键词 Hepatocellular carcinoma Lenvatinib Transarterial chemoembolization Postoperative recurrence Disease-free survival
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Simultaneous versus sequential transcatheter arterial chemoembolization combined with microwave ablation for hepatocellular carcinoma:A retrospective propensity score-matched analysis 认领 引用 被引量：3
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作者 Hong-Yu Wang Gui-Xiong Zhang +5 位作者 Wen-Zhe Fan Jin-Wei Li Shu-Fang Hao Yu-Shu Ouyang Jia-PingLi Wen-Dao Liu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2025年第3期286-293,共8页
Background:Transcatheter arterial chemoembolization(TACE)combined with ablation has better clinical outcomes than monotherapy in patients with hepatocellular carcinoma(HCC).However,prolonged time intervals can lead to... Background:Transcatheter arterial chemoembolization(TACE)combined with ablation has better clinical outcomes than monotherapy in patients with hepatocellular carcinoma(HCC).However,prolonged time intervals can lead to recanalization and neoangiogenesis,which may interfere with the synergistic effects of combination therapy.This study aimed to investigate whether TACE simultaneously combined with microwave ablation(MWA)is more effective than sequential therapy in patients with HCC.Methods:A total of 129 HCC patients who underwent TACE combined with MWA were included in this study.Based on the time interval between the first combination therapy of TACE and MWA,patients were divided into the simultaneous and sequential groups.Propensity score matching(PSM)was performed to reduce bias between the groups.Overall survival(OS),time-to-progression(TTP),tumor response,and liver function were compared.Results:Before PSM,the simultaneous group had a higher tumor load.Following PSM,36 and 40 patients remained in the simultaneous and sequential groups,respectively.The median TTP and OS were 12.9 vs.10.6 months(P=0.262)and 44.0 vs.26.5 months(P=0.313)for the simultaneous and sequential groups,respectively.After 4–8 weeks,there were 16 complete responders and 17 partial responders in the simultaneous group and 15 and 22 patients in the sequential group,respectively(P=0.504).The median complete response duration was 11.3 and 9.2 months for the simultaneous and sequential groups,respectively(P=0.882).These results did not differ in BCLC stratified subgroups.Patients with small tumor sizes(≤5 cm),tumor nodules≤3,well-defined boundaries,and early-stage tumors were more likely to achieve complete response(all P<0.05).After 4–8 weeks,the liver function was significantly improved compared to that before or one day after treatment.Conclusions:TACE simultaneously combined with MWA is safe and effective but not superior to sequential therapy. 展开更多
关键词 Hepatocellular carcinoma Transcatheter arterial chemoembolization Microwave ablation Propensity score
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Comparing transarterial chemoembolization alone to combined transarterial chemoembolization and radiofrequency ablation in primary hepatocellular carcinoma treatment 认领 引用 被引量：1
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作者 Jing Fei Li-Wen Qi +2 位作者 Yuan Liu Min Shu Wen-Qiang Mo 《World Journal of Gastrointestinal Oncology》 SCIE 2025年第4期144-152,共9页
BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide.Transarterial chemoembolization(TACE)combined with percutaneous radiofrequency ablation(RFA)has emerged as a promising t... BACKGROUND Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide.Transarterial chemoembolization(TACE)combined with percutaneous radiofrequency ablation(RFA)has emerged as a promising treatment strategy for patients with unresectable HCC.AIM To evaluate the effectiveness and safety of TACE combined with RFA compared to TACE alone in the management of primary HCC.METHODS A comprehensive retrospective analysis was conducted at our institution from January 2020 to January 2024,involving 106 patients diagnosed with intermediate to advanced-stage HCC.Patients were divided into two groups:Those receiving TACE alone(n=56)and those undergoing combined TACE and RFA therapy(n=50).Treatment efficacy was assessed based on tumor response rates,serum alphafetoprotein(AFP)levels,and survival outcomes.Statistical analyses,includingχ2tests and Kaplan-Meier survival analysis,were performed to compare the outcomes between the two groups.RESULTS The TACE+RFA group demonstrated significantly higher rates of complete response(15 vs 4,P<0.01)and partial response(23 vs 15,P=0.046)compared to the TACE group.Conversely,the TACE group exhibited higher rates of stable disease(25 vs 7,P<0.01)and progressive disease(12 vs 5,P<0.01).Serum AFP levels decreased over time in the TACE+RFA group,while they increased in the TACE group.Survival analysis revealed superior survival outcomes in the TACE+RFA group,with higher survival rates and a prolonged median survival time compared to the TACE group.CONCLUSION The combination of RFA with TACE could offer enhanced treatment response and prolonged survival in patients with primary HCC compared to TACE alone.These findings might support the adoption of multimodal therapeutic approaches,emphasizing the importance of personalized treatment strategies in the management of HCC. 展开更多
关键词 Hepatocellular carcinoma Transarterial chemoembolization Radiofrequency ablation Survival analysis Multimodal therapy Locoregional therapy Synergistic effects
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Personalized prognosis in unresectable hepatocellular carcinoma: Development and validation of a model for transcatheter arterial chemoembolization plus lenvatinib 认领 引用 被引量：1
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作者 Jia-Hui Yu Jun Yu +5 位作者 Jin-Xin Yu Lin-Feng Yang Duan Yan Yi Liu Ju-Rui Xian Peng-Sheng Yi 《World Journal of Gastrointestinal Oncology》 SCIE 2025年第11期153-167,共15页
BACKGROUND Transcatheter arterial chemoembolization(TACE)combined with lenvatinib is an important modality for the treatment of unresectable hepatocellular carcinoma(HCC).To date,no prognostic analysis exists for clin... BACKGROUND Transcatheter arterial chemoembolization(TACE)combined with lenvatinib is an important modality for the treatment of unresectable hepatocellular carcinoma(HCC).To date,no prognostic analysis exists for clinical predictive models of TACE combined with lenvatinib in treating advanced unresectable HCC.A model was constructed through meta-analysis,and its validation was further enhanced by the collection of external clinical data,thereby providing guidance for clinical practice.AIM To identify risk factors for unresectable HCC following TACE plus lenvatinib therapy and to construct a clinical prediction model.METHODS We searched PubMed,Web of Science,EMBASE,and Cochrane Library databases for studies on TACE plus lenvatinib for unresectable HCC.Risk factors from the meta-analysis and sensitivity analyses were used to construct a prediction model.The validation set included clinical data from 106 eligible patients at the Affiliated Hospital of North Sichuan Medical College collected by June 1,2023.RESULTS This study included 43 group studies involving 5070 patients.Tumor number,microvascular invasion,Eastern Cooperative Oncology Group performance status,Child-Pugh stage,Barcelona Clinic Liver Cancer stage,extra-hepatic metastases,alpha-fetoprotein level,and hepatitis B virus status were risk factors for overall survival and progression-free survival,while triple therapy was a protective factor for both.In the validation set,the overall survival prediction model had area under the curve values of 0.616,0.643,and 0.706 at 1 year,2 years,and 3 years,respectively,and the progression-free survival model had area under the curve values of 0.702,0.696,and 0.670 at the corresponding time points,demonstrating good model performance.Calibration curves,Kaplan-Meier survival analysis,and decision curves further validated the efficacy of the model.CONCLUSION Models based on nine variables from 43 group studies predicted the efficacy of TACE plus lenvatinib in unresectable HCC,supporting evidence-based clinical decisions and treatment strategies. 展开更多
关键词 Hepatocellular carcinoma Transcatheter arterial chemoembolization Lenvatinib Prediction model Retrospective study
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Magnetic resonance imaging bias field correction improves tumor prognostic evaluation after transcatheter arterial chemoembolization for liver cancer 认领 引用 被引量：1
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作者 Ke Liu Jun-Biao Li +1 位作者 Yong Wang Yan Li 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第4期207-220,共14页
BACKGROUND Transcatheter arterial chemoembolization(TACE)is a key treatment approach for advanced invasive liver cancer(infiltrative hepatocellular carcinoma).However,its therapeutic response can be difficult to evalu... BACKGROUND Transcatheter arterial chemoembolization(TACE)is a key treatment approach for advanced invasive liver cancer(infiltrative hepatocellular carcinoma).However,its therapeutic response can be difficult to evaluate accurately using conventional two-dimensional imaging criteria due to the tumor’s diffuse and multifocal growth pattern.Volumetric imaging,especially enhanced tumor volume(ETV),offers a more comprehensive assessment.Nonetheless,bias field inhomogeneity in magnetic resonance imaging(MRI)poses challenges,potentially skewing volumetric measurements and undermining prognostic evaluation.AIM To investigate whether MRI bias field correction enhances the accuracy of volumetric assessment of infiltrative hepatocellular carcinoma treated with TACE,and to analyze how this improved measurement impacts prognostic prediction.METHODS We retrospectively collected data from 105 patients with invasive liver cancer who underwent TACE treatment at the Affiliated Hospital of Xuzhou Medical University from January 2020 to January 2024.The improved N4 bias field correction algorithm was applied to process MRI images,and the ETV before and after treatment was calculated.The ETV measurements before and after correction were compared,and their relationship with patient prognosis was analyzed.A Cox proportional hazards model was used to evaluate prognostic factors,with Martingale residual analysis determining the optimal cutoff value,followed by survival analysis.RESULTS Bias field correction significantly affected ETV measurements,with the corrected baseline ETV mean(505.235 cm3)being significantly lower than before correction(825.632 cm3,P<0.001).Cox analysis showed that the hazard ratio(HR)for corrected baseline ETV(HR=1.165,95%CI:1.069-1.268)was higher than before correction(HR=1.063,95%CI:1.031-1.095).Using 412 cm3 as the cutoff,the group with baseline ETV<415 cm3 had a longer median survival time compared to the≥415 cm3 group(18.523 months vs 8.926 months,P<0.001).The group with an ETV reduction rate≥41%had better prognosis than the<41%group(17.862 months vs 9.235 months,P=0.006).Multivariate analysis confirmed that ETV reduction rate(HR=0.412,P<0.001),Child-Pugh classification(HR=0.298,P<0.001),and Barcelona Clinic Liver Cancer stage(HR=0.578,P=0.045)were independent prognostic factors.CONCLUSION Volume imaging based on MRI bias field correction can improve the accuracy of evaluating the efficacy of TACE treatment for invasive liver cancer.The corrected ETV and its reduction rate can serve as independent indicators for predicting patient prognosis,providing important reference for developing individualized treatment strategies. 展开更多
关键词 Invasive liver cancer Transcatheter arterial chemoembolization Magnetic resonance imaging Bias field correction Volume imaging
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