To evaluate the efficacy of the Surefire Infusion System (SIS) for delivery of DEB-TACE in treatment of HCC.

Materials and Methods:
A retrospective review was performed of all patients who under went DEB-TACE for the treatment of HCC with the SIS in a 12-month period. All patients underwent standard angiogram to identify lesions, and treated with 100μm hydrogel microspheres + 50mg Doxorubicin. Treatment location was chosen to be as selective as possible. Patient outcomes were assessed based on mRECIST criteria on follow up imaging.

11 patients with 25 separate HCC lesions (mean size, 3.8cm) under went DEB-TACE treatments using SIS. Of the 24 lesions that were treated with SIS, 12 were de-novo lesions and 12 had previously failed to respond to DEB-TACE using a standard end-hole catheter. With SIS, 15 of 24 (62.5%) of the lesions had complete response (CR), 5 of 24 (20.8%) demonstrated partial response (PR), and 4 lesion had stable disease (SD). Six lesions that did not achieve CR in the first treatment were re-treated with the SIS. Of these, 5 (83.3%) achieved CR. No hepatoxicity was observed; and four patients were successfully downstaged to within Milan criteria.

SIS is a promising tool for delivery of DEB-TACE in treatment of HCC and may lead to improved disease response compared to standard end-hole catheters. In this retrospective study, SIS achieved 83% OR even in lesions that have previously failed DEB-TACE using standard end-hole catheters. A larger, prospective trial is planned to further validate these findings.

Patient Characteristics

59.5 (range 36– 74)

Male: 10
Female: 1

Etiology of Liver Disease
Hepatitis B: 3 (27.3%)
Hepatitis C: 5 (45.5%)
Alcohol Hepatitis: 2 (18.2%)
Nonalcoholic steatohepatitis: 1 (9.1%)

Child-Pugh Classification
A: 9 (81.8%)
B: 2 (18.2%)

Tumor Distribution
Unilobar: 6 (54.4%)
Bilobar: 5 (45.5%)

BCLC Stage
A: 4 (36.4%)
B: 7 (63.6%)

Lesion Characteristics (number of lesions, n=25)

Average Number of Lesions
2.5 (range 1– 6)

Lesion Size Prior to DEB-TACE
3.8cm (range 1.6– 9.0cm)

Viable Lesion Size Prior to First ARM TACE
3.6cm (range 0.8– 9.0cm)