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Original Article Superselective Ablative Chemo-ethanol Embolization for Recurrent Single Hepatocellular Carcinoma: A Six-Month Outcome Analysis
Jae Hwan Lee1,2,3orcid , Kun Young Kim1orcid , Chong-ho Lee1orcid , Minuk Kim4orcid , Chang Jin Yoon1,2,3orcid

DOI: [Accepted]
Published online: May 14, 2024
1Department of Radiology, Seoul National University Bundang Hospital, Gumi-ro 173beongil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
2Department of Radiology, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
3Institute of Radiation Medicine, Seoul National University Hospital, Daehak-ro, Jongno-gu, Seoul, Republic of Korea
4Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
Corresponding author:  Chang Jin Yoon,
Received: 1 April 2024   • Revised: 30 April 2024   • Accepted: 8 May 2024
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To evaluate the safety and effectiveness of superselective ablative chemoethanol embolization (SACE) for the treatment of patients with recurrent single hepatocellular carcinoma (rHCC).
Materials and Methods
This retrospective study included 22 patients (19 men, median age 63 [range 38-86 y]) with Child-Pugh class of A/B/C (16/3/3) that underwent SACE between January and June 2023 for recurrent single HCCs measuring ≤ 5 cm in diameter using a mixture of 99% Ethanol and ethiodized oil/doxorubicin emulsion. The primary endpoint was the 6-month tumor response, and the secondary endpoints were the 1-month tumor response and treatment-related safety. This study was approved by our institutional review board, and the requirement for informed consent was waived.
SACE was successfully performed in 22 (95.2%) patients. The complete response rates at 1-month and 6-month after treatment were 100% and 83.3%, respectively. At 6-month, local tumor progression occurred in one patient and intrahepatic distant metastasis was found in 6 (30%) patients. No 6-month mortalities were reported. No adverse events greater than grade 2 or laboratory deteriorations were observed. Biliary complications or liver abscesses were not observed.
SACE for a single rHCC was highly effective in achieving a favorable 6-month tumor response and showed acceptable adverse events. However, further prospective studies are required to verify these findings.

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