Purpose: The present study aimed to assess the prevalence of vascular lake (VL), its associated factors and correlation with prognosis in hepatocellular carcinoma (HCC) patients treated with drug-eluting bead transarterial chemoembolization (DEB-TACE). 
Patients and Methods: A total of 286 primary HCC patients (with 384 treated nodules) receiving DEB-TACE treatment were recruited, and their clinical characteristics were documented. The occurrence of VL was recorded, and treatment responses were assessed according to the modified response evaluation criteria in solid tumor (mRECIST).In terms of treatment response, the total response status (including CR, PR, SD and PD), objective response rate (ORR) and disease control rate (DCR) were elevated in VL patients compared to non-VL patients as well as in VL nodules compared to non-VL nodules. Liver function indexes and adverse events were assessed. Progression-free survival (PFS) and overall survival (OS) were evaluated with the last follow-up date of March 2020. 
Results: The patient-based and nodule-based VL occurrence rates were 17.1% and 16.4%, respectively. Larger tumor size, pseudocapsules and smaller bead size were independently associated with VL occurrence. PFS and OS were more prolonged in VL patients than in non-VL patients, and VL independently correlated with better PFS and OS. For liver function, the liver function indexes before and after DEB-TACE were of no difference between VL patients and non-VL patients. Additionally, the incidences of adverse events were similar between VL patients and non-VL patients.
Conclusion: VL occurs in 17.1% of HCC patients treated with DEB-TACE, and it is correlated with larger tumor size, pseudocapsule, smaller bead size, more favorable treatment response and better survival.

Keywords: hepatocellular carcinoma, drug-eluting bead transarterial chemoembolization, vascular lake, related factors, efficacy, safety


中文翻译：

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药物洗脱微珠经动脉化疗栓塞治疗肝细胞癌患者血管湖的发生、相关因素及预后价值

目的：本研究旨在评估接受药物洗脱微珠经动脉化疗栓塞（DEB-TACE）治疗的肝细胞癌（HCC）患者血管湖（VL）的患病率、相关因素及其与预后的相关性。 
患者和方法：共招募了 286 名接受 DEB-TACE 治疗的原发性 HCC 患者（384 个治疗结节），并记录了他们的临床特征。记录VL的发生情况，根据改良的实体瘤疗效评价标准（mRECIST）评估治疗反应。在治疗反应方面，总反应状态（包括CR、PR、SD和PD）、客观反应率与非 VL 患者相比，VL 患者的 (ORR) 和疾病控制率 (DCR) 以及与非 VL 结节相比 VL 结节均升高。评估肝功能指标和不良事件。最后一次随访日期为 2020 年 3 月，评估了无进展生存期 (PFS) 和总生存期 (OS)。 
结果：基于患者和基于结节的 VL 发生率分别为 17.1% 和 16.4%。较大的肿瘤大小、假包膜和较小的珠粒大小与 VL 的发生独立相关。VL 患者的 PFS 和 OS 比非 VL 患者更长，并且 VL 与更好的 PFS 和 OS 独立相关。肝功能方面，VL患者与非VL患者DEB-TACE前后肝功能指标无差异。此外，VL 患者和非 VL 患者的不良事件发生率相似。
结论：在接受DEB-TACE治疗的HCC患者中，VL发生率为17.1%，且与肿瘤较大、假包膜、珠粒变小、治疗反应更佳、生存率更高有关。

关键词：肝细胞癌, 药物洗脱珠经动脉化疗栓塞, 血管湖, 相关因素, 疗效, 安全性