The role of transcatheter arterial embolization in patients with resectable hepatocellular carcinoma: a nation-wide, multicenter study.
OBJECTIVE
The role of transcatheter arterial embolization (TAE) for patients with resectable hepatocellular carcinoma (HCC) is controversial. Analyzing a cohort of nation-wide data can delineate the beneficial effect of TAE for those patients.


METHODS
From 1991 to 1995, 818 patients who had potentially resectable HCC from four medical centers in Taiwan were enrolled. Among them, 599 underwent curative resection, 157 received TAE and 62 received supportive treatment alone. The survivals among the three groups were compared.


RESULTS
The 5-year survival rates for patients who underwent surgery, TAE and supportive treatment were 43.6%, 25.6% and 3.7%, respectively. Surgery offered the best survival for those patients. TAE could also prolong survival as compared with supportive treatment (P=0.0001). However, among patients who were in advanced tumor stage (Cancer and the Liver Italian Program (CLIP) score > or =2), no statistical difference in survival was noted between patients who underwent TAE or supportive treatment. In multivariate analysis, single tumor, serum albumin > or =3.5 g/dl, tumor size less than 5 cm, early-stage tumor (CLIP score=0-1) and aggressive treatment including surgery and TAE were independent factors associated with a better survival.


CONCLUSIONS
Surgery is superior to TAE for patients with resectable HCC. In patients who refuse surgery, TAE can be considered for selected patients whose tumors are in early stage.
Huang
Yi-Hsiang
YH
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Chen
Chien-Hung
CH
Chang
Ting-Tsung
TT
Chen
Shinn-Cherng
SC
Wang
Shen-Yung
SY
Lee
Pui-Ching
PC
Lee
Hsuan-Shu
HS
Lin
Pin-Wen
PW
Huang
Guan-Tarn
GT
Sheu
Jin-Chuan
JC
Tsai
Hong-Ming
HM
Chau
Gar-Yang
GY
Chiang
Jen-Huei
JH
Lui
Wing-Yiu
WY
Lee
Shou-Dong
SD
Wu
Jaw-Ching
JC
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002408:Catheters, Indwelling; D004621:Embolization, Therapeutic; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology