Subgrouping of intermediate-stage (BCLC stage B) hepatocellular carcinoma based on tumor number and size and Child–Pugh grade correlated with prognosis after transarterial chemoembolization
详细信息 查看全文
- 作者：Koichiro Yamakado (1)
Shiro Miyayama (2)
Shozo Hirota (3)
Kimiyoshi Mizunuma (4)
Kenji Nakamura (5)
Yoshitaka Inaba (6)
Hiroaki Maeda (3)
Kunihiro Matsuo (7)
Norifumi Nishida (8)
Takeshi Aramaki (9)
Hiroshi Anai (10)
Shinichi Koura (11)
Shigeo Oikawa (12)
Ken Watanabe (13)
Taku Yasumoto (14)
Kinya Furuichi (15)
Masato Yamaguchi (16) - 关键词：Hepatocellular carcinoma ; Arterial embolization ; Prognosis ; Child–Pugh grade ; Tumor number ; Tumor diameter
- 刊名：Japanese Journal of Radiology
- 出版年：2014
- 出版时间：May 2014
- 年：2014
- 卷：32
- 期：5
- 页码：260-265
- 全文大小：
- 参考文献：1. Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003;362:1907-7. CrossRef
2. de Lope CR, Tremosini S, Forner A, Reig M, Bruix J. Management of HCC. J Hepatol. 2012;56(Suppl 1):S75-7. CrossRef
3. Cammà C, Schepis F, Orlando A, Albanese M, Shahied L, Trevisani F, et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials. Radiology. 2002;224:47-4. CrossRef
4. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37:429-2. CrossRef
5. Llovet JM, Real MI, Monta?a X, Planas R, Coll S, Aponte J, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial. Lancet. 2002;359:1734-. CrossRef
6. Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002;35:1164-1. CrossRef
7. Yamakado K, Miyayama S, Hirota S, Mizunuma K, Nakamura K, Inaba Y, et al. Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis? Jpn J Radiol. 2012;30(7):560-. CrossRef
8. Bruix J, Sherman M. Practice guidelines committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005;42:1208-6. CrossRef
9. Bolondi L, Burroughs A, Dufour JF, Galle PR, Mazzaferro V, Piscaglia F, et al. Heterogeneity of patients with intermediate (BCLC B) Hepatocellular Carcinoma: proposal for a subclassification to facilitate treatment decisions. Semin Liver Dis. 2012;32(4):348-9.
10. Mazzaferro V, Llovet JM, Miceli R, Bhoori S, Schiavo M, Mariani L, et al. Metroticket Investigator Study Group. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol. 2009;10(1):35-3. CrossRef - 作者单位：Koichiro Yamakado (1)
Shiro Miyayama (2)
Shozo Hirota (3)
Kimiyoshi Mizunuma (4)
Kenji Nakamura (5)
Yoshitaka Inaba (6)
Hiroaki Maeda (3)
Kunihiro Matsuo (7)
Norifumi Nishida (8)
Takeshi Aramaki (9)
Hiroshi Anai (10)
Shinichi Koura (11)
Shigeo Oikawa (12)
Ken Watanabe (13)
Taku Yasumoto (14)
Kinya Furuichi (15)
Masato Yamaguchi (16)
1. Department of Interventional Radiology, School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
2. Department of Diagnostic Radiology, Fukui-ken Saiseikai Hospital, Fukui, Japan
3. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan
4. Department of Radiology, Ohtawara Red Cross Hospital, Ohtawara, Japan
5. Department of Radiology, Daito Central Hospital, Daito, Japan
6. Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital and Research Institute, Aichi, Japan
7. Department of Radiology, Narumi Hospital, Aomori, Japan
8. Department of Radiology, Osaka City University, Osaka, Japan
9. Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan
10. Department of Radiology, Nara Medical University, Kashihara, Japan
11. Department of Radiology, Fukuoka University, Fukuoka, Japan
12. Department of Radiology, Iwate Prefectural Central Hospital, Morioka, Japan
13. Department of Radiology, Jikei University, Minato, Japan
14. Department of Radiology, Toyonaka Municipal Hospital, Toyonaka, Japan
15. Department of Radiology, Higashiosaka City General Hospital, Osaka, Japan
16. Department of Radiology, Kobe University, Kobe, Japan - ISSN：1867-108X
文摘
Purpose To find a subgroup that benefits most from transarterial chemoembolization (TACE) in terms of tumor number and size and liver profile in patients with intermediate-stage hepatocellular carcinoma (HCC). Materials and methods Data of 325 intermediate-stage HCC patients who received TACE as the initial treatment were gathered. Four tumor numbers (3- tumors) and five maximum tumor diameters (3-?cm) as well as all of their combinations but one (3 tumors and 3?cm) and Child–Pugh grade were used as variables to ascertain prognostic factors. Results The respective 1-, 3-, and 5-year overall survival rates in all patients were 86.5, 47.0, and 23.7?%, respectively. Tumor numbers of 4 (P?=?0.00145) and 5 (P?=?0.036), and tumor size of 7?cm (P?=?0.015), and 12 other combinations of tumor number and size, and Child–Pugh grade (P?=?0.0015) were identified as significant prognostic factors in univariate analysis, and 4 tumors of 7?cm (P?=?0.0008) and Child–Pugh grade (P?=?0.0036) remained significant in the stepwise Cox proportional hazard model. The overall survival was significantly better in a patient subgroup having two factors other than patient subgroups having one or no prognostic factors. Conclusion A patient subgroup having two prognostic factors benefited most from TACE in intermediate-stage HCC patients.