Comparison of ethanol-soaked gelatin sponge and microspheres for hepatic arterioportal fistulas embolization in hepatic cellular carcinoma

Table 1 Grading of arterioportal fistula

Grade	Definition	Class
0	APFs were not observed	-
1	APFs flow to the subsegmental portal branch	Mild
2	APFs flow to the segmental portal branch	Moderate
3	APFs flow into the main portal branch of the ipsilateral lobe	Moderate
4	APFs flow into the main portal branch of the contralateral lobe and/or the main portal vein	Severe
5	APFs flow into the main portal vein presenting with hepatofugal portal venous flow	Severe

APF: Arterioportal fistula.

Table 2 Demographic and baseline characteristics

Characteristics	E group (n = 46)	M group (n = 45)	χ2	P value
Sex, n (%)			0.029	0.865
Male	33 (71.7)	33 (73.3)
Female	13 (28.3)	12 (26.7)
Age (yr)	63.4 ± 8.5	58.4 ± 10.1	-	0.092
Etiology, n (%)			0.909	0.952
HBV	38 (82.7)	39 (86.8)
HCV	4 (8.7)	2 (4.4)
HBV + HCV	2 (4.3)	2 (4.4)
Alcohol	2 (4.3)	2 (4.4)
Child-Pugh stage, n (%)			0.297	0.586
A	25 (54.3)	27 (60)
B	21 (45.7)	18 (40)
BCLC stage, n (%)			0.271	0.873
A	7 (15.2)	6 (13.3)
B	19 (41.3)	21 (45.7)
C	20 (43.5)	18 (40)
Tumor location			0.837	0.658
Right lobe	30 (65.2)	28 (62.2)
Left lobe	9 (19.6)	10 (22.2)
Right and left lobes	7 (15.2)	7.1 ± 1.6
Mean tumor diameter (cm)	6.8 ± 2.9		-	0.765
Portal vein thrombus			0.098	0.754
Present	24 (52.2)	22 (48.9)
Absent	22 (47.8)	23 (51.1)
Previous treatment			1.639	0.925
Surgery	7 (15.2)	6 (13.3)
MWA/RFA	9 (19.6)	7 (15.6)
TACE	4 (8.7)	5 (11.1)
Radiation	4 (8.7)	6 (13.3)
TACE + MWA/RFA	2 (4.3)	3 (6.7)
None	20 (43.5)	18 (40)
AFP [ng/mL, median (IQR)]	137 (9.8, 970.1)	114.9 (3.7, 725.7)	-	0.734
APF grade, n (%)			2.689	0.636
1	5 (10.9)	6 (13.3)
2	15 (32.6)	16 (35.6)
3	11 (23.9)	14 (31.1)
4	9 (19.6)	7 (15.6)
5	6 (13)	2 (4.4)

HCV: Hepatitis C virus; BCLC: Barcelona Clinic Liver Cancer; MWA: Microwave ablation; RFA: Radiofrequency ablation; TACE: Transcatheter arterial chemoembolization; AFP: Alpha-fetoprotein; IQR: Interquartile range; APFs: Arterioportal fistulas.

Table 3 Outcome characteristics

Characteristics	E group (n = 46)	M group (n = 45)	χ2	P value
Tumor response after four months (%)			10.578	0.014
CR	18 (39.1)	8 (17.8)
PR	21 (45.7)	18 (40)
SD	4 (8.7)	15 (33.3)
PD	3 (6.5)	4 (8.9)
DCR	43 (93.5)	41 (91.1)		0.714
ORR	42 (91.3)	30 (66.7)	8.358	0.004
Immediate improvement of APF (%)			-	0.485
Yes	43 (93.5)	40 (88.9)	-
No	3 (6.5)	5 (11.1)
First-time follow-up APF improvement (%)			0.646	0.421
Improved	37 (80.4)	33 (73.3)
Not improved	9 (19.6)	12 (26.7)
AFP after 4 mo [ng/mL, median (IQR)]	28.48 (4, 257.9)	45.25 (4.43, 359.5)		0.045
Child-Pugh score after 4 mo (%)			5.321	0.083
A	33 (71.7)	23 (51.1)
B	10 (21.7)	20 (44.4)
C	3 (6.6)	2 (4.5)
OS, months (mean ± SD)	26.2 ± 1.4	20.6 ± 1.1	10.3	0.004
PFS, months (mean ± SD)	16.6 ± 1.0	13.8 ± 0.7	6.3	0.012

CR: Complete response; PR: Partial response; SD: Stable disease; PD: Progressive disease; DCR: Disease control rate; ORR: Objective response rate; APFs: Arterioportal fistulas; AFP: Alpha-fetoprotein; AP: Arterioportal; IQR: Interquartile range; OS: Overall survival; PFS: Progression-free survival.