Top Pearls for Liver Therapy Presented at CIO 2019

Friday, October 11, 2019 (Miami, FL) — Providing attendees with practical take-home tips for the treatment of liver cancer was the purpose of the final session on day one of the Symposium on Clinical Interventional Oncology (CIO).

Isabel Newton, MD, PhD, UC San Diego, summarized her approach in the use of drug-eluting embolics. Her primary message was consistency. Since there is no evidence that any one protocol is superior to another, she urged attendees to select a treatment protocol and to be consistent in its use and follow-up in order to evaluate outcomes from the protocol over time. Her rationale for using drug-eluting bead transarterial chemoembolization (DEB-TACE) was described.

Tips for delivering conventional transarterial chemoembolization (cTACE) were offered by Sarah White, MD, MS, FSIR, Associate Professor of Radiology and Surgical Oncology, Vice Chair, Radiology Research, Medical Director, Vascular Access Team, Medical College of Wisconsin. Strategies for recognizing and treating postembolization syndrome (PES) were outlined. Other tips included methods to ensure proper emulsion technique.

Karen T. Brown, MD, University of Utah School of Medicine, provided several take-home points on bland embolization. Her first recommendation was to "know your embolics." Attendees should consider general anesthesia, especially when embolizing solitary lesion for “cure.” Small, tightly calibrated particles should be targeted for selective embolization, particularly solitary lesions. The usefulness of immediate post embolization computed tomography (CT), combination therapy for solitary hepatocellular carcinoma (HCC), and post-embolization biopsy were discussed.

Balloon-occluded TACE (B-TACE) was covered in the session from Yasuaki Arai, MD, from the National Cancer Center in Japan. He began with a review of types of microballoon catheters and their function, and discussed changes in hemodynamics under balloon occlusion. After reviewing numerous studies in the literature, he concluded that tumor control and survival rate seem better in B-TACE compared with cTACE, but no significant difference in overall survival has yet been shown.

The risks of performing ablation near the diaphragm and heart were outlined by Raul Uppot, MD, from the Department of Radiology at Massachusetts General Hospital in Boston and Assistant Professor, Harvard Medical School. He emphasized that dome/diaphragm ablation cases pose special challenges. Techniques for avoiding cardiac and lung injury, as well as severe pain, were provided.

Presenters included Nadine Abi-Jaoudeh, MD, describing her use of cone beam CT and encouraging standardization of protocols; William Rilling, MD, on portal vein embolization; and Marcelo Guimaraes, MD, who discussed ablating near the liver surface and the importance of obtaining adequate margins, and thermal protective techniques.

About the Symposium on Clinical Interventional Oncology (CIO)

Renowned for its originality, practicality, and focus on improving patient care, CIO, an HMP event, highlights the most viable and sought-after treatments in the rapidly expanding field of interventional oncology. CIO is led by course directors Ripal Gandhi, MD; Ziv Haskal, MD; Constantino Peña, MD; Daniel Sze, MD; and Alda Tam, MD. The program contains a mix of didactic lectures, case presentations and debates between experts, hands-on workshops, and pre-recorded cases woven together with audience interactivity through polling and question and answer sessions. For more information, visit theiomeeting.com.

About HMP 

HMP is the force behind Healthcare Made Practical – and is a multichannel leader in health care events and education, with a mission to improve patient care. The company produces accredited medical education events and clinically relevant, evidence-based content for the global health care community across a range of therapeutic areas. Its brands include Consultant360, the year-round, award-winning platform relied upon by primary care providers and other specialists; Psych Congress, the largest independent mental health meeting in the U.S.; EMS World Expo, North America’s largest EMT and paramedic event; and the Symposium on Advanced Wound Care (SAWC), the largest wound care meeting in the world. For more information, visit hmpglobal.com.