Katerina Malagari

Biography

Katerina Malagari Scientific Department Cardiovascular and Interventional Radiological Society of Europe Katerina Malagari Athens State University , Athens · Department of Radiology Radiology  

Research Interest

a report by Katerina Malagari Associate Professor of Radiology, University of Athens Hepatocellular carcinoma (HCC) is among the 10 most common neoplasms worldwide and the third highest cause of cancer-related deaths, 1 with geographical variation in incidence and risk factors. 1,2 Surgical methods remain the gold standard for the treatment of HCC. However, this is feasible in only 25–30% of patients because of tumour stage or the severity of underlying cirrhosis. Transarterial chemoembolisation (TACE) is generally accepted as an effective palliative treatment for patients with unresectable HCC and adequate preservation of liver function. The justification of chemoembolisation as a palliative treatment for HCC has been strengthened by recent randomised trials and meta-analysis of previous smaller randomised trials, while a significant survival benefit has been shown compared with no treatment or systemic chemotherapy. 3–6 TACE has been shown to reduce systemic toxicity and increase local effects and thus improve therapeutic results. There is no generally accepted TACE technique. The core concept includes selective embolisation of tumour-feeding arteries with a chemotherapeutic agent in an emulsion with idodised oil and subsequent embolisation with a particulate agent. The embolising material slows and obstructs intra- tumoral flow, creating ischaemia and increasing the contact time between the chemotherapeutic agent and the tumour cells, while the iodinated oil produces obstruction of the arterial and portal vein branches through the peribiliary plexus. In addition, tumour cell ischaemia causes tumour cell membrane changes, resulting in intracellular retention of the chemotherapeutic drugs. The chemotherapeutic regime varies considerably between centres, as does the choice of embolisation agent – including non-permanent embolic material such as absorbable gelatine powder or polyvinyl alcohol particles, gelatine-coated tris-acryl embospheres or biocompatible polyvinyl alcohol hydrogels (bead block).