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
Factors predictive of 5-year survival after transarterial chemoembolization for inoperable hepatocellular carcinoma†
Article first published online: 19 FEB 2003
Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 90, Issue 3, pages 325–331, March 2003
How to Cite
O'Suilleabhain, C. B., Poon, R. T. P., Yong, J. L., Ooi, G. C., Tso, W. K. and Fan, S. T. (2003), Factors predictive of 5-year survival after transarterial chemoembolization for inoperable hepatocellular carcinoma. Br J Surg, 90: 325–331. doi: 10.1002/bjs.4045
- Issue published online: 19 FEB 2003
- Article first published online: 19 FEB 2003
- Manuscript Accepted: 20 SEP 2002
Transarterial chemoembolization (TACE) is widely used for unresectable hepatocellular carcinoma (HCC), but the long-term survival benefit remains unclear.
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.
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.
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.