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Safety and Efficacy of Transcatheter Arterial Chemoemboliazation in the Real-Life Management of Unresectable Hepatocellular Carcinoma

AUTHORS

Argyro Mazioti 1 , Nikolaos K. Gatselis 2 , Christos Rountas 1 , Kalliopi Zachou 2 , Dimitrios K. Filippiadis 1 , Kostantinos Tepetes 3 , George K. Koukoulis 4 , Ioannis Fezoulidis 1 , George N. Dalekos 2 , *

AUTHORS INFORMATION

1 Department of Radiology, Medical School, University Hospital of Larissa, University of Thessaly, Larissa, Greece

2 Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece

3 Department of Surgery, Medical School, University Hospital of Larissa, University of Thessaly, Larissa, Greece

4 Department of Pathology, Medical School, University of Thessaly, Larissa, Greece

ARTICLE INFORMATION

Hepatitis Monthly: 13 (8); 7070
Published Online: August 12, 2013
Article Type: Brief Report
Received: July 2, 2012
Accepted: November 17, 2012
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Abstract

Background: Trans-arterial chemoembolization (TACE) is associated with better survival in BCLC-stage B patients with hepatocellular carcinoma (HCC) and Child-Pugh A whereas in Child-Pugh B there is no definite evidence of benefit.

Objectives: To assess the safety and efficacy of TACE during routine clinical practice in a consecutive Greek cohort of patients with unrespectable HCC.

Patients and Methods: Seventy one patients enrolled for this study (mean follow-up:24.6 months). 100 mg cisplatin, 50 mg doxorubicin and 10 ml lipiodol as well as embolic materials were used. CT-scans and blood tests were obtained prior and post-TACE. KaplanMeier method and Cox proportional hazard model were used to evaluate survival and factors affecting survival.

Results: Survival at 1-year, 2-years, 3-years and 5-years was 73.2%, 45.4%, 33.2% and 14.9% respectively. Procedure-related mortality was 1.4%. Multivariate analysis showed lesion diameter, Child-Pugh classification, alcohol abuse, tumor response and AFP prior TACE as independent prognostic factors of survival. Patients diagnosed during surveillance had significantly better survival rates compared to those diagnosed after development of symptoms (HR = 0.58, 95%CI: 0.33-1.01, P < 0.05).

Conclusions: TACE is safe and efficient for unrespectable HCC. Alcohol abuse, tumor burden, response criteria, Child-Pugh and AFP prior to the session were identified as independent predictors of survival whereas, adherence to surveillance programs resulted in significantly better survival in these patients.

Keywords

Chemoembolization, Therapeutic Carcinoma, Hepatocellular Liver Cirrhosis Hepatitis B Virus Hepatitis C

© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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