Comparison of transarterial chemoembolization and percutaneous acetic acid injection as the primary loco-regional therapy for unresectable hepatocellular carcinoma: a prospective survey
Article first published online: 4 JUN 2004
Alimentary Pharmacology & Therapeutics
Volume 19, Issue 12, pages 1301–1308, June 2004
How to Cite
Huo, T., Huang, Y.-H., Wu, J.-C., Chiang, J.-H., Lee, P.-C., Chang, F.-Y. and Lee, S.-D. (2004), Comparison of transarterial chemoembolization and percutaneous acetic acid injection as the primary loco-regional therapy for unresectable hepatocellular carcinoma: a prospective survey. Alimentary Pharmacology & Therapeutics, 19: 1301–1308. doi: 10.1111/j.1365-2036.2004.01996.x
- Issue published online: 4 JUN 2004
- Article first published online: 4 JUN 2004
- Accepted for publication 30 March 2004
Background : Transarterial chemoembolization (TACE) and percutaneous acetic acid injection (PAI) are effective loco-regional therapies for hepatocellular carcinoma (HCC).
Aim : To compare the therapeutic efficacy of TACE vs. PAI for unresectable HCC.
Methods : A total of 310 patients with unresectable HCCs (size ≤6 cm) undergoing TACE (n = 195) or PAI (n = 115) were studied prospectively. Overall and progression-free survivals were measured endpoints.
Results : The overall survival was not significantly different between the two groups (P = 0.508). Among 129 patients with large (3.1–6 cm) HCCs, the overall survival was significantly better for the TACE group (P = 0.018). Cox multivariate analysis showed that Child-Pugh B [relative risk (RR): 4.2, 95% confidence interval (CI): 2.3–7.7, P < 0.001] and PAI therapy (RR: 1.4, 95%: 1.0–1.9, P = 0.057) were poor prognostic predictors; the progression-free survival was also significantly better in the TACE group (P = 0.038). Among 181 patients with small (≤3 cm) HCCs, there was no significant difference of overall survival (P = 0.265) or progression-free survival (P = 0.146) between the two groups; Child-Pugh B was the only prognostic factor predicting a decreased survival (RR: 2.8, 95% CI: 1.7–4.8, P < 0.001).
Conclusions : Patients with large HCC undergoing TACE tend to have a more favourable long-term outcome. For small HCC, either TACE or PAI therapy could be recommended as the primary treatment modality.