Unresectable hepatocellular carcinoma: analysis of prognostic factors in transcatheter management.
OBJECTIVE
To evaluate the effect of transcatheter management of hepatocellular carcinoma (HCC) on survival.


METHODS
A prospective trial of transcatheter arterial embolization (TAE) was performed in patients with unresectable HCC. Three hundred twenty-two patients (265 men, 57 women; age range, 30-83 years) underwent TAE alone: 60 patients underwent TAE with gelatin sponge (GS) that contained anticancer agents (protocol 1); 78, TAE with GS and iodized oil mixed with anticancer agents (protocol 2); and 159, TAE with iodized oil with anticancer agents (protocol 3). A Cox proportional hazard model was used to analyze prognostic factors.


RESULTS
In the randomized group (n = 272), survival rates for protocols 1, 2, and 3 were 80.4%, 86.3%, and 65.9%, respectively, at 1 year. Findings of analysis of prognostic factors showed that extrahepatic metastases, ascites, tumor extension, and icterus were the important factors.


CONCLUSIONS
TAE with GS was superior to TAE without GS. Patient characteristics were important factors for survival.
Hatanaka
Y
Y
Department of Radiology, Kumamoto University School of Medicine, Japan.
Yamashita
Y
Y
Takahashi
M
M
Koga
Y
Y
Saito
R
R
Nakashima
K
K
Urata
J
J
Miyao
M
M
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate