Efficacy of glass membrane emulsification device in conventional transarterial chemoembolization for hepatocellular carcinoma: a preliminary study

BACKGROUND: Transarterial chemoembolization (TACE) is the standard treatment for Barcelona Clinic Liver Cancer (BCLC)-B hepatocellular carcinoma (HCC). A novel glass membrane emulsification device (GMD) produces a high percentage of water/oil emulsions with homogeneous and stable droplets. There are few reports on the efficacy of GMD-conventional-TACE (GMD-c-TACE); therefore, we aimed to evaluate the effectiveness of GMD-c-TACE. METHODS: Seventy-one patients with HCC with tumor diameter <5 cm who underwent c-TACE with and without GMD were included in this study to investigate local recurrence and hepatic functional reserve. RESULTS: The local recurrence rates of TACE without GMD were 3.0% at 6 months, 16.7% at 12 months, and 35.0% at 18 months, around where it plateaued. In contrast, the local recurrence rates in the GMD-c-TACE group were 0.0% at 12 months and 15.4% at 18 months, respectively. Thus, GMD-c-TAE had a significantly lower local recurrence. ALBI score of c-TACE with GMD significantly preserved hepatic reserve. Multivariate analysis showed that GMD-c-TACE could suppress local recurrence and maintain hepatic reserve. CONCLUSIONS: GMD-c-TACE allows dense lipiodol accumulation in the tumor and the attainment of good local control. Additionally, in vitro evaluation of the sustained release properties of GMD, the inhibition of the release of anticancer drugs may lead to maintain hepatic reserve. GMD-c-TACE is useful in preventing local recurrence and is expected to become the standard treatment form of c-TACE in the future.