•The ability of CRAFITY score in predicting prognosis for patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) is unknown.•The CRAFITY score demonstrated good predictive ability for overall survival but poor accuracy for predicting objective response rates among patients with unresectable HCC undergoing TACE combined with systemic therapies.•The CRAFITY score can be used to predict overall survival for patients with unresectable HCC undergoing TACE combined with tyrosine kinase inhibitors, with or without checkpoint inhibitors.
Thermal ablation for renal cell carcinoma in nephron-sparing surgery has been extensively investigated. However, data regarding renal pelvic tumors with refractory hematuria are scarce. Herein, we report a case of recurrent hematuria in an 87-year-old woman with. a 3.5 × 4.1 cm mass in the right renal pelvis on imaging examinations, which was clinically diagnosed as renal pelvic carcinoma. After ineffective renal artery embolization, minimally invasive percutaneous thermal ablation was recommended after a multidisciplinary consultation. Although hematuria was successfully relieved after ultrasound-guided radiofrequency ablation initially, recurrence of hematuria was reported due to tumor progression after one year. CT-guided microwave ablation resolved hematuria and controlled tumor growth without complications. Upper tract urothelial carcinoma (UTUC) was confirmed by biopsy. Postoperative CT imaging, urine cytology, and renal function tests were continuously monitored during the follow-up. The patient remained stable during the 1-year follow-up period, highlighting the potential of thermal ablation for refractory hematuria in renal pelvis urothelial carcinoma while preserving nephrons.
Objective: The present study aimed to assess the diagnostic efficacy of baseline spectral computed tomography (CT) parameters in predicting tumor response to transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: Data were collected from 91 consecutive patients with HCC between June 2020 and July 2023. An independent samples t-test was performed to compare the demographic and spectral CT variables between the groups. Predictors were screened using binary logistic regression, and the diagnostic efficacy of the baseline parameters for predicting the response to TACE in patients with HCC was analyzed using receiver operating characteristic (ROC) curves. Results: A total of 91 patients with HCC were included in the present study, categorized into response (n = 52; men, 48 (92.3 %); age, 58.72 ± 11.16 years) and non-response (n = 39; men, 36 (92.31 %); age, 59.50 ± 10.10 years) groups based on the evaluation criteria. There was a statistically significant difference in both iodine concentration (IC) and normalized IC (NIC) between the two groups (P < 0.05), and we found that the mean values of the three IC and NIC phases in the non-response group were significantly lower than those in the response group. The arterial, portal, and delayed phase ICs and NICs had significant positive effects on the response to TACE in patients with HCC (P < 0.05). Baseline spectral CT parameters, including IC and NIC, had satisfactory diagnostic efficacy for predicting tumor response to TACE (area under the curve [AUC] of baseline spectral parameters ranged from 0.698 to 0.879). The results of the DeLong test indicated no statistical differences between the AUC of all the parameters and models. Conclusion: The present study found that the baseline spectral CT parameters could be surrogate imaging markers for predicting tumor response to TACE.
Expert consensus proposes an emergency treatment protocol for portal hypertension bleeding. Herein, the emergency treatment procedures, which include first aid, medical, interventional, and surgical treatments, are described. In addition, the indications, contraindications, operating norms, precautions, and prevention of complications of portal hypertension are described to optimize the first aid process.
