Abstract
BackgroundEffective treatment options for nonresectable hepatic carcinoma (HC) in dogs are limited.Hypothesis/ObjectiveObjectives were to report outcomes, complications, and tumor responses via computed tomography (CT) assessment after drug‐eluting bead transarterial chemoembolization (DEB‐TACE) for nonresectable HC in dogs. The authors hypothesized that major complications would be uncommon and short‐term CT assessment would demonstrate stable disease or partial response.AnimalsClient‐owned dogs (n = 16) with nonresectable HC.MethodsProspective, single‐arm clinical trial. Drug‐eluting bead transarterial chemoembolization was performed to varying levels of blood flow stasis. Computed tomography imaging was compared before and approximately 12 weeks after initial treatment.ResultsDrug‐eluting bead transarterial chemoembolization was successfully administered in all attempts. Based on percent change in elliptical tumor volume response (mL), stable disease (8/13; 62%) was the most common outcome followed by partial response (3/13; 23%) and progressive disease (2/13; 15%) with a median of 74 days (range, 39‐125) after initial treatment. Median tumor volume (mL) after DEB‐TACE decreased in volume by 13% (range, 56% decrease to 77% increase). Mild complications consistent with postembolization syndrome occurred after 7/27 (26%) treatments. Major complications occurred after 3/27 (11%) treatments: hepatic abscess/septicemia (2) and cholecystitis/death (1), resulting in treatment‐induced death after 2/27 (7%) treatments. Median survival time after treatment was 337 days (range, 22‐1061). Dogs with a presenting complaint of weight loss (P = .02) had a significantly shorter median survival time (126 days; range, 46‐337) than those dogs without prior history of weight loss (582 days; range, 22‐1061).ConclusionsDrug‐eluting bead transarterial chemoembolization for nonresectable HC is a feasible procedure, which promoted stable disease or partial response in 85% of dogs in this study sample.
Highlights
Sixteen dogs diagnosed with nonresectable hepatic carcinoma (HC), either naïve tumors (12/16; 75%) or those with suspected regrowth after previous excision (4/16; 25%) and treated with DEB-transarterial chemoembolization (TACE) at The Animal Medical Center satisfied study inclusion criteria
The results of this study showed that DEB-TACE treatment for nonresectable HC could be performed successfully, resulted in few major complications, and resulted in 77% of tumors displaying a reduction in volume on follow-up computed tomography angiography (CTA)
Drug-eluting bead transarterial chemoembolization could emerge as a viable treatment alternative for dogs with nonresectable HC
Summary
Hepatic carcinomas (HCs) are the most common primary liver neoplasm in dogs with hepatocellular carcinoma (HCC) comprising the most common subset,[1,2,3] followed by bile duct carcinomas,[2,4,5,6] and hepatic neuroendocrine carcinomas.[4,7,8] For massive, resectable HCs, complete surgical resection is recommended.[3,9,10] The prognosis for dogs with focal, resectable HC is good with surgical intervention (range, >1460 to >1836 days)[3,9,10,11]; there is minimal information regarding the efficacy of nonsurgical treatment modalities for nonresectable disease.In humans, transarterial embolization (TAE) or transarterial chemoembolization (TACE) are important components of treatment for nonresectable HC.[12,13,14,15,16,17] TAE involves transcatheter superselective arterial injections of embolic agents into the tumor-feeding arteries resulting in targeted ischemic necrosis.[18,19] Drug-eluting bead TACE (DEB-TACE) delivers higher doses of chemotherapeutic agents with longer drug-tumor contact times by administering embolic beads which slowly elute chemotherapeutics locally, reducing systemic adverse effects.[19]. Hypothesis/Objective: Objectives were to report outcomes, complications, and tumor responses via computed tomography (CT) assessment after drug-eluting bead transarterial chemoembolization (DEB-TACE) for nonresectable HC in dogs. The authors hypothesized that major complications would be uncommon and short-term CT assessment would demonstrate stable disease or partial response. Drug-eluting bead transarterial chemoembolization was performed to varying levels of blood flow stasis. Results: Drug-eluting bead transarterial chemoembolization was successfully administered in all attempts. Based on percent change in elliptical tumor volume response (mL), stable disease (8/13; 62%) was the most common outcome followed by partial response (3/13; 23%) and progressive disease (2/13; 15%) with a median of 74 days (range, 39-125) after initial treatment. Median tumor volume (mL) after DEB-TACE decreased in volume by 13% (range, 56% decrease to 77% increase). Major complications occurred after 3/27 (11%) treatments: hepatic abscess/
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