Selective and sequential transarterial chemoembolization: survival in patients with hepatocellular carcinoma

Eur J Radiol. 2012 Sep;81(9):2290-7. doi: 10.1016/j.ejrad.2011.09.010. Epub 2011 Oct 5.

Abstract

Purpose: To assess the survival time of patients with HCC following transarterial chemoembolization performed in a highly selective and sequential way.

Patients and methods: 124 HCC patients (102 male, 22 female; mean age 63±11 years) treated with selective and sequential chemoembolization at a single center were included. Selective chemoembolization was performed through a coaxially introduced microcatheter in a segmental or subsegmental hepatic artery. Treatment was stopped after complete stasis of the blood flow in the tumor-feeding vessel. The primary endpoint of the study was overall survival.

Results: The median overall survival of the entire patient population was 27.2 months (mo) (±8.9 mo, 95% CI 9.8 mo, 44.6 mo). When stratified according to liver function the median survival was 46.1 mo (±9.0 mo; 95% CI 28.5 mo, 63.7 mo) for Child-Pugh A and 11.1 mo (±4.3 mo; 95% CI 2.7 mo, 19.5 mo) for Child-Pugh B (p<.001). The median survival was 46.1 mo (±16.6 mo; 95% CI 13.5 mo, 78.7 mo) for BCLC stage A, 19.7 mo (±2.6 mo; 95% CI 14.6 mo, 24.8 mo) for BCLC stage B, and 14.4 mo (±5.0 mo; 95% CI 4.5 mo, 24.3 mo) for BCLC stage C (p<.01).

Conclusion: Selective and sequential chemoembolization offers long survival times in patients with HCC. Those patients with preserved liver function benefit more than patients with limited liver reserve.

Publication types

  • Clinical Trial

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Hepatocellular / mortality*
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / mortality*
  • Ethiodized Oil / therapeutic use*
  • Female
  • Germany / epidemiology
  • Hemostatics / therapeutic use
  • Humans
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Mitomycin / therapeutic use*
  • Prevalence
  • Risk Factors
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Hemostatics
  • Mitomycin
  • Ethiodized Oil