Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis?

Abstract

PURPOSE:

To evaluate retrospectively whether technical factors of hepatic arterial embolization affect the prognosis of patients with hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

Inclusion criteria of this study were the following: (1) patients received embolization as the initial treatment during 2003-2004, (2) Child A or B liver profile, (3) five or fewer HCCs with maximum diameter of 7 cm or smaller, and (4) no extrahepatic metastasis. Patient data were gathered from 43 centers. Prognostic factors were evaluated using univariate and multivariate analyses.

RESULTS:

Eight hundred fifteen patients were enrolled. The 1-, 3-, 5-, and 7-year overall survival rates were 92.0 % (95 % CI 90.1-93.9), 62.9 % (95 % CI 59.3-66.6), 39.0 % (95 % CI 35.1-43.0), and 26.7 % (95 % CI 22.6-30.8) in all patients. Univariate analysis showed a Child-Pugh class-A, alpha-fetoprotein level lower than 100 ng/ml, tumor size of 3 cm or smaller, tumor number of 3 or fewer, one-lobe tumor distribution, nodular tumor type, within the Milan criteria, stage I or II, no portal venous invasion, use of iodized oil, and selective embolization were significantly better prognostic factors. In the multivariate Cox model, the benefit to survival of selective embolization remained significant (hazard ratio 0.68; 95 % CI 0.48-0.97; p = 0.033).

CONCLUSION:

Selective embolization contributes to survival in patients with HCCs.

• Authors: Koichiro Yamakado, Shiro Miyayama, Shozo Hirota, Kimiyoshi Mizunuma, Kenji Nakamura, Yoshitaka Inaba, Akihiro Maeda, Kunihiro Matsuo, Norifumi Nishida, Takeshi Aramaki, Hiroshi Anai, Shinichi Koura, Shigeo Oikawa, Ken Watanabe, Taku Yasumoto, Kinya Furuichi, Masato Yamaguchi
• Journal: Japanese journal of radiology (Jpn J Radiol) Vol. 30 Issue 7 Pg. 560-6 (Aug 2012) ISSN: 1867-108X [Electronic] Japan
• PMID: 22644412 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• alpha-Fetoproteins
• Iodized Oil

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (therapy)
• Chemoembolization, Therapeutic (methods)
• Disease Progression
• Female
• Hepatic Artery
• Humans
• Iodized Oil (administration & dosage)
• Liver Neoplasms (therapy)
• Male
• Middle Aged
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Survival Rate
• alpha-Fetoproteins (analysis)