Bronchial artery embolization for hemoptysis caused by metastatic hepatocellular carcinoma

• Published in: Scientific reports 2022-04, Vol.12 (1), p.6906-6906, Article 6906
• Main Authors: Kim, Sungwon, Kim, Jin Hyoung, Ko, Gi-Young, Gwon, Dong Il, Shin, Ji Hoon, Yoon, Hyun-Ki
• Format: Article
• Language: English
• Subjects: 692/1807; 692/4028; 692/699; Antitumor activity; Bronchial Arteries; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - therapy; Embolization; Hemoptysis; Hemoptysis - drug therapy; Hemoptysis - therapy; Hepatocellular carcinoma; Humanities and Social Sciences; Humans; Liver cancer; Liver Neoplasms - drug therapy; Liver Neoplasms - therapy; Lung carcinoma; Lung Neoplasms - drug therapy; Lung Neoplasms - therapy; Metastases; Metastasis; multidisciplinary; Neoplasm Recurrence, Local - drug therapy; Patients; Polyvinyl alcohol; Polyvinyl Alcohol - therapeutic use; Retrospective Studies; Science; Science (multidisciplinary); Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-10972-9

Because of its extremely rare incidence, the safety and efficacy of bronchial artery embolization (BAE) for the treatment of hemoptysis caused by pulmonary metastasis from HCC are not well known. We therefore evaluated the safety and efficacy of BAE in these patients. Data from 18 patients with hepatocellular carcinoma (HCC) and pulmonary metastasis who received BAE for the treatment of hemoptysis between 2003 and 2021 were retrospectively reviewed. Technical and clinical success were achieved in 100% and 94% of patients, respectively. Of the 18 embolization procedures, six were performed using polyvinyl alcohol (PVA) particles only, five were performed using gelfoam only, three were performed using gelfoam plus microcoils, one was performed using PVA plus microcoils, one was performed using embospheres, one was performed using lipiodol plus PVA and gelfoam, and one was performed using hystoacryl with microballoon protection. In eight patients for whom CT just before BAE and at follow-up were available, the mean size of the largest metastatic tumor decreased from 5.1 to 3.7 cm ( P  = 0.035). Hemoptysis recurred in three patients (17%) during follow-up. The median overall and hemoptysis-free survival periods were 149 days and 132 days, respectively. BAE is an effective and safe option for the treatment of hemoptysis in patients with pulmonary metastasis from HCC, with a favorable clinical success rate and a low rate of hemoptysis recurrence. In addition, we also observed BAE to have a positive antitumor effect on pulmonary metastases from HCC, but this requires confirmation in a future study.