Survival benefit of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma larger than 10 cm in diameter

Authors

  • Y.-H. HUANG,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
    3. Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
    Search for more papers by this author
  • J.-C. WU,

    1. Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
    2. Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
    Search for more papers by this author
  • S.-C. CHEN,

    1. Hepatobiliary Division, Department of Internal Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    Search for more papers by this author
  • C.-H. CHEN,

    1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    Search for more papers by this author
  • J.-H. CHIANG,

    1. Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
    Search for more papers by this author
  • T.-I. HUO,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
    Search for more papers by this author
  • P.-C. LEE,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    Search for more papers by this author
  • F.-Y. CHANG,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
    Search for more papers by this author
  • S.-D. LEE

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
    Search for more papers by this author

Dr J.-C. Wu, Department of Medical Research and Education, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 112, Taiwan.
E-mail: jcwu@vghtpe.gov.tw

Abstract

Summary

Background

The safety and survival benefit of transcatheter arterial chemoembolization for patients with huge hepatocellular carcinoma is uncertain.

Aim

To evaluate the role of embolization in unresectable hepatocellular carcinomas larger than 10 cm.

Methods

Twenty-six consecutive patients who had an unresectable hepatocellular carcinoma larger than 10 cm and refused aggressive treatment, were enrolled as the control group. Another 31 patients matching with the control cases and undergoing embolization for huge unresectable hepatocellular carcinoma served as the embolization group. Survival between the two groups was compared.

Results

Two patients (7%) died from embolization-related complications. Patients in embolization group had longer survival than those in control group (median survival: 9.13 vs. 2.1 months). The 1-, 3- and 5-year survival rates in embolization group were 42%, 13% and 7% respectively. The 1- and 3-year survival rates for patients in control group were 8% and 0% respectively. In multivariate analysis, embolization and prothrombin ratio ≤1.2 were two independent factors associated with a better survival.

Conclusions

Embolization-related mortality is low for huge hepatocellular carcinoma, and the technique provides survival benefit in patients with unresectable hepatocellular carcinomas larger than 10 cm in diameter.

Ancillary