Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2024; 16(1): 102-109
Published online Jan 15, 2024. doi: 10.4251/wjgo.v16.i1.102
Comparative study between Embosphere® and Marine gel® as embolic agents for chemoembolization of hepatocellular carcinoma
Hyo-Cheol Kim, Jin Woo Choi
Hyo-Cheol Kim, Jin Woo Choi, Department of Radiology, Seoul National University Hospital, Seoul 03080, South Korea
Author contributions: Kim HC designed the research study and performed the research; Kim HC and Choi JW analyzed the data and wrote the manuscript; and all authors have read and approve the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Seoul National University Hospital.
Informed consent statement: The informed consent was waived by the institutional review board.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyo-Cheol Kim, MD, Professor, Department of Radiology, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 03080, South Korea. radioembolization@snu.ac.kr
Received: September 3, 2023
Peer-review started: September 3, 2023
First decision: October 30, 2023
Revised: November 12, 2023
Accepted: December 8, 2023
Article in press: December 8, 2023
Published online: January 15, 2024
Abstract
BACKGROUND

While gelatin sponge particles and calibrated microspheres are commonly used as embolic materials in conventional transarterial chemoembolization (cTACE), direct comparisons between these embolic agents are rare.

AIM

To compare the efficacy and safety of superselective cTACE using Embosphere® or Marine gel® in patients with early-stage hepatocellular carcinoma (HCC).

METHODS

This retrospective study included 70 patients with small (< 4 cm) HCC who underwent cTACE with Embosphere® (n = 33) or Marine gel® (n = 37) as the embolic agent at a single center between March 2021 and July 2022. The radiologic images and clinical data were retrospectively reviewed, with an emphasis on tumor response, procedure-related complications, and local tumor recurrence. The primary index tumor was assessed on a 1-mo follow-up image, and local progression-free survival was obtained using the Kaplan-Meier method and was compared by the log-rank test.

RESULTS

The median tumor size of both groups was 1.5 cm, and 69 patients achieved a complete response one month after cTACE. The cumulative local recurrence rate at 12 mo was 15.5% in the Embosphere® group and 14.4% in the Marine gel® group. The local progression-free survival was not significantly different between the two groups (P = 0.83). In the multivariate analysis, high serum alpha-fetoprotein was the only significant poor prognostic factor for local tumor progression (P = 0.01). Postembolization syndrome occurred in 36.4% of the Embosphere® group and 35.1% of the Marine gel® group, and there were no cases of biloma, biliary duct dilation, or liver abscess in either group.

CONCLUSION

Calibrated gelatin sponge particles (Marine gel®) and calibrated microspheres (Embosphere®) have similar outcomes in terms of tumor response for superselective cTACE of small HCC.

Keywords: Hepatocellular carcinoma, Chemoembolization, Temporary embolic material, Permanent embolic material, Tumor response

Core Tip: Conventional chemoembolization, a main treatment option for unresectable hepatocellular carcinoma (HCC), involves delivery of anticancer drug and embolic materials. The current study aimed to assess the tumor response of superselective chemoembolization using calibrated gelatin sponge particles and calibrated microspheres as embolic materials. There is no significant difference in tumor response between the use of calibrated gelatin sponge particles and calibrated microspheres for conventional chemoembolization in small HCC.