Transcatheter arterial chemoinfusion (TACI) is the main treatment modality for advanced
hepatocellular carcinoma (HCC). However, the therapeutic efficacy of TACI according to anti-
cancer agents and prognostic factors for advanced HCC (TNM stage IVa) has not been previously clarified. A total of 127 patients with TNM stage IVa HCC were divided into intra-arterial
Adriamycin (Group I) and intra-arterial
Cisplatin (Group II) infused groups, according to the
anticancer agents that were used. We compared the therapeutic efficacy of TACI applied
anticancer agents, and we also analyzed the prognostic factors which influenced the survival rates. Chi-square test, t- test, Cox's proportional hazard regression model, and Kaplan- Meier method were performed. The overall survival was significantly different (10.0 vs 5.7 months, respectively) and the results favored Group I. On univariate analysis, the significant prognostic factors included age, portal vein
thrombosis (PVT),
tumor size (diameter > 5 cm), type of
tumor, the reduction rate (
tumor size and
alpha- fetoprotein) after 3 months of
chemotherapy,
serum albumin level, serum
alkaline phosphatase level and total serum
bilirubin levels at the time of diagnosis. After repeated
chemotherapy, Group I showed better survival (14.0 vs 7.9 months). However, there was no statistical difference in the survival rate of the two groups for cases involving large
tumors, PVT and diffuse type of HCC. Group I showed better survival than Group II. However, when the other prognostic factors were taken into consideration, there was no significant difference in the survival rate of the two groups, except for the cases with small or nodular HCC.