Bland Embolization in Hepatocellular Carcinoma Patients with Borderline Liver Functions, 1 Year Survival Rate

Background: To determine efficacy and monitor safety of bland embolization in patients with hepatocellular carcinoma (HCC) and high bilirubin level. Method(s): From January 2017 to June 2018, 25 consecutive HCC patients who were Child-Pugh class b with high bilirubin level (> 2 mg/dl and < 4 mg/dl) and no ascites and no signs of extrahepatic disease were treated selectively with bland embolization (PVA 150-250 µm for HCC < 5 cm and 255-350 µm > 5 cm) using a microcatheter. Mean age was 55 years, 16 (64%) were males. Abdominal ultrasound was done after 1 week to detect ascites. Liver functions was done after 1 week to detect any change then after 1 month then every 3 months for 1 year. Follow up with triphasic CT was performed after 1 month then every 3 months for 1 year. Result(s): After 1 week, decompensated ascites was noted in two patients (8%). After 1 month, complete response was detected in 15 cases (60%), partial response in 10 cases (40%). Three cases (12%) died during the follow up. Overall survival rates at 12 months was 88%. Conclusion(s): Bland embolization is effective and safe in Child-Pugh class b patients with HCC with high survival rate at 12 months.