The Role of Transarterial Bland Embolization in Management of Hepatocellular Carcinoma in Child-Pugh-Turcotte (B) Patients

El Sheikh, Hesham El Sayed El Sayed; El-Din Mohamed, Osama Zain; Shalaan, Ahmed; Abdelmoniem, Ahmed

doi:10.21608/bmfj.2025.343489.2280

The Role of Transarterial Bland Embolization in Management of Hepatocellular Carcinoma in Child-Pugh-Turcotte (B) Patients

Document Type : Original Article

Authors

¹ Professor & Head of Diagnostic & Interventional Radiology Department, Faculty of Medicine - Benha University

² Consultant of Diagnostic and Interventional Radiology, Military Medical Academy

³ Lecturer of Diagnostic and Interventional Radiology Department, Faculty of Medicine - Benha University

⁴ Diagnostic &amp; Interventional Radiology Department Faculty of Medicine - Benha University

10.21608/bmfj.2025.343489.2280

Abstract

Background: HCC is a major global health challenge. TACE is the first-line non-curative therapy for certain cases However, patients in CPT-B or C are cautioned against TACE due to an increased risk of liver failure and mortality, particularly with non-selective lobar chemoembolization approaches. Advances in super-selective embolization techniques have mitigated these risks, creating new therapeutic options for patients with compromised liver function. This study aimed to evaluate the tumor response of transarterial bland embolization in (CPT-B) patients with HCC.
Methods: This prospective study evaluated the tumor response of TABE in 25 CPT-B patients with HCC over one year. The TABE procedure, conducted under fluoroscopic guidance, involved hepatic arteriography and super-selective embolization using size-specific embolic materials. Post-treatment, tumor response was assessed through imaging and alpha-fetoprotein levels. Results: participants with a single lesion were more likely to achieve a complete response. In contrast, the mean largest lesion dimension was significantly smaller in participants who achieved a complete response compared to those who did not (4.2 ± 1.4 cm vs. 6.2 ± 1.9 cm, P = 0.007). The best cutoff point of Child-Paugh score to predict incomplete response was > 8, at which sensitivity, specificity, PPV, and NPV were 66.7%, 100%, 100%, and 84.2%, respectively. Child-Pugh score remained a significant predictor OR = 10.891, 95% CI: 1.097–108.116, P = 0.041). Conclusion: TABE is an effective treatment modality for HCC in CPT-B patients, achieving a complete response in the majority of cases with Child-Pugh score being the strongest predictor.

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