title: Transcatheter arterial chemoembolization therapy for patients with hepatocellular carcinoma: a case-controlled study.
abstract: OBJECTIVE
  Transcatheter arterial chemoembolization (TACE) currently is used as a palliative treatment for patients with unresectable hepatocellular carcinoma (HCC), but its efficacy still is debated. Our aim was to assess the impact of TACE on patient survival and to identify prognostic factors for survival.
  
  
  METHODS
  Fifty-six cirrhotic patients with unresectable HCC undergoing at least 1 course of TACE were matched 1:1 for sex, age (in 5-year periods), parameters of Child-Pugh score, Okuda stage, and tumor type with a control group who had received only supportive care.
  
  
  RESULTS
  The 2 groups were comparable for cause of cirrhosis, alpha-fetoprotein serum levels, and Cancer of the Liver Italian Program (CLIP) score. The 56 patients in the TACE group received a total of 123 treatment courses. The median follow-up period was 16 months (range, 1-67 mo) in the TACE group and 5 months (range, 1-77 mo) in the supportive care group. Survival rates at 12, 24, and 30 months in patients receiving TACE were 74.3%, 52.1%, and 38.8%, respectively, with a median survival time of 25 months, whereas in supportive care patients the rates were 39.4%, 25.4%, and 19%, respectively, with a median survival time of 7 months (P = .0004). At univariate analysis, TACE, tumor type, presence of ascites, alpha-fetoprotein serum level, CLIP score, and Okuda stage were associated significantly with survival. Only TACE and CLIP score proved to be independent predictors of survival at multivariate analysis.
  
  
  CONCLUSIONS
  TACE is an effective therapeutic option for cirrhotic patients with unresectable HCC and a CLIP score of 3 or less.
authors.affiliation: Semeiotica Medica, Dipartimento Medicina Interna, Cardioangiologia ed Epatologia, Università di Bologna, Via Massarenti 9, 40138 Bologna, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Biselli
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
authors.forename: Annagiulia
authors.initials: A
authors.lastname: Gramenzi
authors.forename: Franco
authors.initials: F
authors.lastname: Trevisani
authors.forename: Carmela
authors.initials: C
authors.lastname: Cursaro
authors.forename: Cristina
authors.initials: C
authors.lastname: Rossi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Ricca Rosellini
authors.forename: Carlo
authors.initials: C
authors.lastname: Cammà
authors.forename: Stefania
authors.initials: S
authors.lastname: Lorenzini
authors.forename: Giuseppe Francesco
authors.initials: GF
authors.lastname: Stefanini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
mesh_terms: D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016022:Case-Control Studies; D002423:Cause of Death; D016461:Chemoembolization, Therapeutic; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D015251:Epirubicin