Concerns About Untreated Liver Cancer Growth After TACE Procedure

After the embolization of a 5 cm liver cancer, there are still 2 cm of cancer cells remaining?

Hello Doctor, my father has HCC measuring 3.2×4.8×3.4 cm in segment 3.
He underwent TACE embolization in mid-March, and a CT scan on May 6 showed a remaining tumor measuring 1.3×1.8 cm that did not receive the embolization agent.
After evaluation, the hospital physician has determined that he can undergo radiofrequency ablation, but the earliest available date is June 17.
I am very concerned about how quickly this liver cancer tumor might grow or change during these three weeks.
Thank you for your assistance, and I appreciate your response.

Ms. Hsu, 40~49 year old female. Ask Date: 2021/05/23

Dr. Chen Shidian reply Gastroenterology and Hepatology

The rate of change varies for each individual.
If fetal protein levels are low before or after embolization, the changes may occur more slowly.
During the pandemic, we can only say to proceed as quickly as possible.

Reply Date: 2021/05/23

More Info

After undergoing a Transarterial Chemoembolization (TACE) procedure for hepatocellular carcinoma (HCC), it is understandable to have concerns about the growth of untreated tumors. In your father's case, the presence of a residual tumor measuring 1.3 × 1.8 cm after TACE indicates that not all cancerous tissue was effectively treated. This situation raises valid questions about the potential for tumor growth during the waiting period before the scheduled radiofrequency ablation (RFA) on June 17.

The growth rate of liver tumors can vary significantly among individuals and depends on several factors, including the tumor's biological characteristics, the patient's overall health, liver function, and the presence of underlying liver disease such as cirrhosis. Generally, HCC can exhibit aggressive behavior, particularly in patients with underlying liver conditions. However, the growth rate can be slow in some cases, especially if the tumor is well-differentiated and the patient has a good liver function.

In the three-week interval before the RFA, it is possible for the tumor to grow, but the extent of growth can be unpredictable. Some studies suggest that HCC tumors can double in size within a few weeks to months, while others may remain stable for longer periods. The key is to monitor the situation closely. If there are any symptoms such as increased abdominal pain, jaundice, or changes in overall health, it is crucial to contact the healthcare provider immediately.

In terms of management, it is essential to maintain regular follow-ups with imaging studies to assess the tumor's status. If there are concerns about rapid growth or changes in the tumor's characteristics, the healthcare team may consider alternative interventions or expedite the planned RFA.

Regarding the timing of RFA after TACE, it is generally recommended to wait a few weeks to allow for the effects of the embolization to stabilize. However, if there is significant concern about tumor growth, the healthcare provider may adjust the timing based on clinical judgment and the patient's condition.

In summary, while there is a possibility that the untreated tumor may grow during the waiting period, the actual rate of growth can vary. It is essential to stay in close communication with the healthcare team, report any new symptoms, and ensure that follow-up imaging is conducted as needed. The focus should be on timely intervention and comprehensive management of your father's condition to optimize outcomes.

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