Factors predictive of 5-year survival after transarterial chemoembolization for inoperable hepatocellular carcinoma

Authors

  • C. B. O'Suilleabhain,

    1. Department of Surgery, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
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  • R. T. P. Poon,

    Corresponding author
    1. Department of Surgery, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
    • Department of Surgery, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
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  • J. L. Yong,

    1. Department of Surgery, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
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  • G. C. Ooi,

    1. Department of Radiology, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
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  • W. K. Tso,

    1. Department of Radiology, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
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  • S. T. Fan

    1. Department of Surgery, Centre for the Study of Liver Disease, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China
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  • Presented to the Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland, Dublin, Ireland, May 2002, and published in abstract form as Br J Surg 2002; 89(Suppl 1): 62

Abstract

Background:

Transarterial chemoembolization (TACE) is widely used for unresectable hepatocellular carcinoma (HCC), but the long-term survival benefit remains unclear.

Methods:

Pretreatment variables were analysed for factors predictive of actual 5-year survival from a prospective database of patients with inoperable HCC treated by TACE between 1989 and 1996.

Results:

Complete 5-year follow-up (median 91 months) was obtained for 320 patients who underwent a median of 4 (range 1–41) TACEs. Median tumour size was 9 (range 1–28) cm. There were 25 5-year survivors (8 per cent), including eight with tumours larger than 10 cm in diameter and three with portal vein branch involvement. On univariate analysis, female gender (P = 0·037), absence of ascites (P = 0·028), platelet count below 150 ×109 per litre (P = 0·011), albumin concentration greater than 35 g/l (P = 0·04), α-fetoprotein level below 1000 ng/ml (P = 0·007), unilobar tumour (P = 0·027), fewer than three tumours (P = 0·015), absence of venous invasion (P = 0·011), and tumour diameter less than 8 cm (P = 0·021) were significant predictors of 5-year survival. Albumin concentration greater than 35 g/l (P = 0·011), unilobar tumour (P = 0·012) and α-fetoprotein level below 1000 ng/ml (P = 0·014) were independent prognostic factors on multivariate analysis.

Conclusion:

Five-year survival is possible with TACE for inoperable HCC, even in some patients with advanced tumours. Unilobar tumours, α-fetoprotein level below 1000 ng/ml and albumin concentration greater than 35 g/l were factors predictive of 5-year survival. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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