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.
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Yi-Hsiang
YH
Huang
Chien-Hung
CH
Chen
Ting-Tsung
TT
Chang
Shinn-Cherng
SC
Chen
Shen-Yung
SY
Wang
Pui-Ching
PC
Lee
Hsuan-Shu
HS
Lee
Pin-Wen
PW
Lin
Guan-Tarn
GT
Huang
Jin-Chuan
JC
Sheu
Hong-Ming
HM
Tsai
Gar-Yang
GY
Chau
Jen-Huei
JH
Chiang
Wing-Yiu
WY
Lui
Shou-Dong
SD
Lee
Jaw-Ching
JC
Wu
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