Transarterial Chemoembolization for the Treatment of Advanced-Stage Hepatocellular Carcinoma

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• 作者：Yan Zhao ; Rafael Duran ; Julius Chapiro ; Jae Ho Sohn…
• 关键词：Hepatocellular carcinoma ; Transarterial chemoembolization ; Overall survival ; Barcelona Clinic Liver Cancer
• 刊名：Journal of Gastrointestinal Surgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：20
• 期：12
• 页码：2002-2009
• 全文大小：370 KB
• 刊物主题：Surgery; Gastroenterology;
• 出版者：Springer US
• ISSN：1873-4626
• 卷排序：20

文摘

It remains controversial whether transarterial chemoembolization (TACE) should be performed in patients with advanced-stage hepatocellular carcinoma (HCC). The present large retrospective cohort study aimed to define the survival outcome following TACE of advanced HCC and to identify the prognostic factors. Five hundred eight patients with Barcelona Clinic Liver Cancer (BCLC) C-stage HCC, Child-Pugh A/B who were treated with TACE between November 1998 and December 2013 were identified. There was no significant difference in overall survival (OS) between patients with Eastern Cooperative Oncology Group (ECOG) 0 and those with ECOG ≥1 (10.5 months vs. 11.9 months, P = 0.87). The median OS of patients without portal vein tumor thrombosis (PVTT) was longer than that of patients with PVTT (16.9 vs. 6.1 months, P < 0.001). Child-Pugh B class, PVTT, extrahepatic metastasis, tumor size ≥5 cm, number of tumors ≥3, and alpha-fetoprotein ≥400 ng/dL were significantly associated with decreased survival and were used for determining the risk scores. All patients were divided into two groups (low-risk and high-risk groups) according to the cutoff value of 6.5 for risk scores. The patients with a value <6.5 (low-risk group) had significantly longer survival than those with >6.5 (high-risk group) (24.1 vs. 7.5 months, respectively; P < 0.001). TACE is an effective therapy for select patients with advanced stage HCC and may provide equal or improved survival as compared with reported outcomes with sorafenib. The results highlight the need for a differentiated approach to therapeutic recommendations for patients with BCLC C.