Abstract
Background: Transcatheter arterial embolization (TAE) is regarded as an effective treatment for patients with symptomatic hepatic hemangioma. However, few studies have evaluated the efficacy of TAE alone for treating hepatic hemangioma. The aim of this study was to identify the factors that influence the response to TAE and formulate a quantitative nomogram to optimize the individualized management of hepatic hemangioma. Methods: We retrospectively studied 276 patients treated with TAE for hepatic hemangioma at our center from January 2011 to December 2019. The full cohort was randomly divided into training and validation cohorts. After assessing the potential predictive factors for the efficacy of TAE in the training cohort, a nomogram model was established and evaluated by discrimination and calibration. Results: During follow-up, the symptom relief rate was 100%. The tumor blood supply (p < 0.001), tumor number (p = 0.004), and tumor size (p = 0.006) were identified as significant predictors of the failure of tumor shrinkage in response to TAE. The nomogram model showed favorable discrimination and calibration, with a C-index of 0.775 (95% CI, 0.705–0.845) in the training cohort, which was further confirmed in the validation cohort (C-index 0.768; 95% CI, 0.680–0.856). The side effects of TAE were relatively minor and included mainly abdominal pain, nausea, vomiting, fever, and the presence of elevated hepatic transaminases. Conclusion: TAE is a safe and effective treatment for symptomatic hepatic hemangioma. The established nomogram performed well for the estimation of the effect of TAE in patients with hepatic hemangioma and can facilitate the selection of patients who would benefit most from the treatment.
Highlights
Hepatic hemangioma is the most common benign vascular lesion of the liver with an approximate incidence ranging from 0.4 to 20% (Choi and Nguyen, 2005; Fang et al, 2015)
The nomogram model showed favorable discrimination and calibration, with a concordance index (C-index) of 0.775 in the training cohort, which was further confirmed in the validation cohort (C-index 0.768; 95% CI, 0.680–0.856)
A multicenter study involving 836 cases reported that transarterial chemoembolization was safe and effective for treating giant hepatic hemangioma, and the results showed a 100% symptom relief rate and clear tumor regression (Li et al, 2015)
Summary
Hepatic hemangioma is the most common benign vascular lesion of the liver with an approximate incidence ranging from 0.4 to 20% (Choi and Nguyen, 2005; Fang et al, 2015). Transcatheter arterial embolization (TAE) is a promising, minimally invasive technique for the treatment of symptomatic hepatic hemangioma, associated with symptom relief and marked tumor shrinkage (Srivastava et al, 2001). A multicenter study involving 836 cases reported that transarterial chemoembolization was safe and effective for treating giant hepatic hemangioma, and the results showed a 100% symptom relief rate and clear tumor regression (Li et al, 2015). The present study aimed to investigate the potential factors correlating with the efficacy of TAE and to develop a nomogram for the management of individual hepatic hemangioma. Transcatheter arterial embolization (TAE) is regarded as an effective treatment for patients with symptomatic hepatic hemangioma. The aim of this study was to identify the factors that influence the response to TAE and formulate a quantitative nomogram to optimize the individualized management of hepatic hemangioma
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