title: Transcatheter arterial chemoembolization (TACE) in treatment of hepatocellular carcinoma.
abstract: OBJECTIVE
  Substantial differences about the efficacy of transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma are reported in literature. This probably depends on the fact that in each single study, different patient selection criteria, type of epidemiological approach, end points adopted and kind of technical approach were used. This study aims to evaluate the efficacy of segmental transcatheter arterial chemoembolization in amelioring patient survival and to determine which patients might really benefit from this treatment.
  
  
  METHODS
  To achieve our goals 193 consecutive patients (110 treated and 83 untreated) were studied. They were selected in the same period of time and matched as far as their demographic and clinical characteristics.
  
  
  RESULTS
  Our results demonstrate that both in treated and control patients, Child class, alpha-fetoprotein and tumor diameter significantly influenced survival, resulting important prognostic factors. Transcatheter arterial chemoembolization significantly ameliorated survival in treated patients compared to controls (p < 0.0001).
  
  
  CONCLUSIONS
  Transcatheter arterial chemoembolization significantly ameliorates survival in patients with hepatocellular carcinoma. However, the presence of large tumors producing high alpha-fetoprotein levels in patients with advanced Child class should discourage treatment.
authors.affiliation: Dept. of Emergency and Organ Transplantation, Section of Gastroenterology, University di Bari, Policlinico Piazza G. Cesare, 11, 70124 Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Barone
authors.forename: Giovanni Carlo
authors.initials: GC
authors.lastname: Ettorre
authors.forename: Roberta
authors.initials: R
authors.lastname: Ladisa
authors.forename: Marianna
authors.initials: M
authors.lastname: Schiavariello
authors.forename: Cosima
authors.initials: C
authors.lastname: Santoro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Francioso
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vinciguerra
authors.forename: Antonio
authors.initials: A
authors.lastname: Francavilla
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D002404:Catheterization; D016461:Chemoembolization, Therapeutic; D004317:Doxorubicin / Q000008:administration & dosage* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000627:therapeutic use*; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D016685:Mitomycin; D004317:Doxorubicin