Society of Interventional Radiology Position Statement on….pdfVIP

Society of Interventional Radiology Position Statement on Chemoembolization of Hepatic Malignancies Daniel B. Brown, MD, Jean-Francois H. Geschwind, MD, Michael C. Soulen, MD, Steven F. Millward, MD, and David Sacks, MD J Vasc Interv Radiol 2006; 17:217–223 Abbreviation: HCC hepatocellular carcinoma PRIMARY and secondary malignan- ing for approximately half these causing metabolically active cell mem- cies in the liver present one of the most deaths. More than 56,000 patients died brane pumps to fail, thereby in- challenging problems in clinical oncol- from colon cancer in 2002 and it is creasing intracellular retention of the ogy. Hepatocellular carcinoma (HCC) predicted that there will be more than chemotherapeutic drugs (9). Recent re- is one of the most common fatal ma- 145,000 new cases of colorectal cancer search has demonstrated that ischemia lignancies worldwide, with more than diagnosed in the United States in 2005 can increase angiogenesis in tumor 530,000 new cases diagnosed annually (3). Other tumors that frequently de- cells, possibly spurring tumor growth (1). The prevalence of hepatoma in the velop fatal hepatic metastases despite (10–12). These molecular changes United States is rapidly increasing as a a treatable primary tumor include oc- raise questions about whether chemo- result of the spread of chronic infec- ular melanoma, neuroendocrine tu- embolization or hepatic arterial embo- tion with hepatitis C. Currently mors, and gastrointestinal sarcoma. lization is the better method to per- 10,000–15,000 cases of HCC are diag- Chemoembolization combines he- form endovascular hepatic arteri