Transcatheter arterial chemoembolization (TACE) in treatment of hepatocellular carcinoma.
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.
Barone
Michele
M
Dept. of Emergency and Organ Transplantation, Section of Gastroenterology, University di Bari, Policlinico Piazza G. Cesare, 11, 70124 Bari, Italy.
Ettorre
Giovanni Carlo
GC
Ladisa
Roberta
R
Schiavariello
Marianna
M
Santoro
Cosima
C
Francioso
Giuseppe
G
Vinciguerra
Vincenzo
V
Francavilla
Antonio
A
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
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D016685:Mitomycin; D004317:Doxorubicin