Hepatic arterial infusion chemotherapy with use of an implanted port system in patients with advanced hepatocellular carcinoma: prognostic factors.
OBJECTIVE
This study was retrospectively undertaken to identify prognostic factors in patients with advanced hepatocellular carcinoma (HCC) treated by hepatic arterial infusion chemotherapy with a percutaneously implantable port system inserted.


METHODS
Eighty-eight patients underwent arterial infusion chemotherapy for portal venous invasion (n = 39), severe liver dysfunction (n = 6), or tumor regrowth after chemoembolization, percutaneous ethanol injection therapy, and surgery (n = 77). Twenty-five variables representing patients' characteristics, previous treatments, tumor characteristics, liver profiles, various staging systems, and therapeutic effect were analyzed with univariate and multivariate analyses.


RESULTS
The 1- and 3-year survival rates were 55% and 24%, respectively, with a mean survival period of 19.5 months +/- 1.9 in all patients. Cancer of the Liver Italian Program (CLIP) score, Okuda stage, therapeutic effect, tumor extension, alkaline phosphatase and aspartate aminotransferase levels, ascites, and portal venous invasion were identified as significant prognostic factors by univariate analysis. Multivariate analysis identified CLIP score, Okuda stage, and therapeutic effect as significant independent prognostic factors.


CONCLUSIONS
Although our results should be confirmed in future prospective studies, the prognostic factors identified in the present study should prove helpful in classifying patients with advanced HCC who are treated by arterial infusion chemotherapy and should serve as useful guidelines on arterial infusion chemotherapy in clinical practice.
Hamada
Ayumi
A
Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. ayumi@clin.medic.mie-u.ac.jp
Yamakado
Koichiro
K
Nakatsuka
Atsuhiro
A
Takaki
Haruyuki
H
Akeboshi
Masao
M
Takeda
Kan
K
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000009:adverse effects / Q000295:instrumentation*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D015251:Epirubicin; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil