Impact of the Interval between Transarterial Chemoembolization Sessions on Survival in Patients with Unresectable Hepatocellular Carcinoma

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• 作者：Hyung-Don Kim ; MD^a ; Jihyun An ; MD^a ; Jin Hyoung Kim ; MD^b ; Dong Il Gwon ; MD^b ; Ji Hoon Shin ; MD^b ; Gi-Young Ko ; MD^b ; Hyun-Ki Yoon ; MD^b ; Kyu-Bo Sung ; MD^b ; Kang Mo Kim ; MD^a ; ^{kimkm70@amc.seoul.kr" class="auth_mail" title="E-mail the corresponding author} ; Han Chu Lee ; MD^a
• 关键词：CI ; confidence interval ; HCC ; hepatocellular carcinoma ; HR ; hazard ratio ; INR ; international normalization ratio ; mRECIST ; modified response evaluation criteria in solid tumor
• 刊名：Journal of Vascular and Interventional Radiology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：27
• 期：4
• 页码：504-513
• 全文大小：1226 K

文摘

To evaluate clinical impact of different intervals between multiple transarterial chemoembolization sessions in patients with unresectable hepatocellular carcinoma (HCC).

Materials and Methods

A retrospective cohort study of 305 consecutive patients with HCC who underwent multiple sessions of on-demand transarterial chemoembolization by two independent physicians with different management policies in terms of transarterial chemoembolization interval was performed; 180 patients had intervals between the first and second transarterial chemoembolization session of < 60 days (short-interval group), and 125 patients had transarterial chemoembolization intervals of ≥ 60 days (conventional-interval group).

Results

The short-interval group had more cases of advanced-stage HCC, less favorable response to transarterial chemoembolization, and higher likelihood of having Child-Pugh class A. The short-interval group underwent more transarterial chemoembolization sessions (6.6 vs 5.5, P = .011), although the total number of admissions and total hospital stay were similar to the conventional-interval group. Overall survival was similar in the two groups in the full and the propensity score–matched cohorts. Although the overall survival of patients with Child-Pugh class A was comparable between the two groups in the full and propensity score–matched cohorts, the short-interval group showed inferior survival (P = .005) and a nonsignificant trend toward inferior survival (P = .117) in the full and propensity score–matched cohorts, respectively, for patients with Child-Pugh class B.

Conclusions

Transarterial chemoembolization interval did not affect survival outcomes of patients with Child-Pugh class A. A shorter transarterial chemoembolization interval showed a nonsignificant trend of adversely affecting survival for patients with Child-Pugh class B.