Long-Term Outcomes of Transarterial Chemoembolization of Giant Liver Hemangiomas with Lipiodol-Bleomycin Emulsion.

Purpose: To evaluate the safety, efficacy, and long-term outcomes of transarterial chemoembolization (TACE) with bleomycin-Lipiodol for giant liver hemangiomas.

Materials And Methods: Single-center retrospective study from 1998 to January 2020, including patients with giant liver hemangiomas treated with bleomycin-Lipiodol TACE and followed up >36 months. The exclusion criteria were defined as patients who had been treated but had no available follow-up above 3 years and patients who had previously been treated with any other treatment method. Clinical success was defined as the disappearance of symptoms and radiological success (responded vs. non-responded groups) as a more than 50% decrease in the volume of the giant hemangioma in follow-up CT or MRI compared to the baseline images.

Results: A total of 121 patients were included. The mean maximum diameter of the hemangiomas decreased from 122 (range: 40-300) to 73 mm (range: 15-240), and the mean volume reduced from 984.4 (range: 30-7312) to 286.6 cm (range: 1-3835). There were 106 patients in the responded group, while only 15 patients were in the non-responded group. No significant difference was found in size and volume change percentages across these two groups based on gender, age, lesion size, lesion volume, lesion number, and second TACE. When the follow-up period was stratified in 5-year periods, the maximum volume decrease was observed in the first 5-year period and then remained constant up to > 15 years.

Conclusion: TACE with bleomycin-Lipiodol is safe, reducing the size and volume of giant liver hemangiomas with stable results in the long-term follow-up.