title: Prognostic factors in patients with advanced hepatocellular carcinoma receiving hepatic arterial infusion chemotherapy.
abstract: BACKGROUND
  The prognosis of patients with advanced hepatocellular carcinoma (HCC) is poor. We aimed to clarify the prognostic factors in patients with advanced HCC receiving hepatic arterial infusion chemotherapy (HAIC).
  
  
  METHODS
  Forty-four HCC patients were treated with HAIC, using low-dose cisplatin (CDDP) and 5-fluorouracil (5-FU) with/without leucovorin (or isovorin). Of these 44 patients, 15 received low-dose CDDP and 5-FU, and 29 received low-dose CDDP, 5-FU, and leucovorin or isovorin. Prognostic factors were evaluated by univariate and multivariate analyses of patient and disease characteristics.
  
  
  RESULTS
  Of all patients, 5 and 12 patients respectively, exhibited a complete response (CR) and a partial response (PR) (response rate, 38%). The response rate (48.3%) in the low-dose CDDP and 5-FU with leucovorin/isovorin group was significantly better than that (20%) in the low-dose CDDP and 5-FU group (P = 0.002). The 1-, 2-, 3-, and 5-year cumulative survival rates of the 44 patients were 39%, 18%, 12%, and 9%, respectively. The regimen using low-dose CDDP and 5-FU with leucovorin/isovorin tended to improve survival rates (P = 0.097). Univariate and multivariate analyses showed the same variables--the Child-Pugh score (P = 0.013, P = 0.018), alpha-fetoprotein (AFP) level (P = 0.010, P = 0.009), and therapeutic effect after HAIC (P = 0.003, P = 0.01), respectively, to be significant prognostic factors.
  
  
  CONCLUSIONS
  Patients who had advanced HCC with favorable hepatic reserve capacity and a lower AFP level were suitable candidates for HAIC. Moreover, the regimen using low-dose CDDP and 5-FU with leucovorin/isovorin may be suitable for advanced HCC patients, because of the improvement in the response rate and survival compared with the low-dose CDDP and 5-FU regimen without leucovorin/isovorin.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube 755-8505, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Teruaki
authors.initials: T
authors.lastname: Kimura
authors.forename: Fumie
authors.initials: F
authors.lastname: Kurokawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Aoyama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Tajima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Taro
authors.initials: T
authors.lastname: Takami
authors.forename: Kaoru
authors.initials: K
authors.lastname: Omori
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kawaguchi
authors.forename: Masako
authors.initials: M
authors.lastname: Tsuchiya
authors.forename: Shuji
authors.initials: S
authors.lastname: Terai
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D002423:Cause of Death; D002945:Cisplatin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery / Q000737:chemistry* / Q000187:drug effects*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007564:Japan / Q000453:epidemiology; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014803:Vitamin B Complex / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D014803:Vitamin B Complex; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil