title: [The efficacy of hepatic arterial infusion therapy for advanced hepatocellular carcinoma according to extrahepatic collateral feeding vessels].
abstract: OBJECTIVE
  Despite the poor response rate of 20-30%, hepatic arterial infusion therapy (HAIT) has been often tried for advanced hepatocellular carcinoma with portal vein tumor thrombosis or ineffective response to other treatments. The factors that predict treatment response to HAIT remain unclear. This study ascertained the response rate to HAIT based on the existence of extrahepatic collateral feeding vessels or anatomical variants.
  
  
  METHODS
  Forty one patients received repeated HAIT using an implanted drug delivery system. Of the 41 patients, 18 patients were treated with 5-FU, epirubicin and mytomycin-C; 17 patients were treated with 5-FU and cisplatin; and 6 patients were treated with 5-FU, cisplatin and leucovorin. The patients were divided into two groups according to the existence of extrahepatic collateral feeding vessels or anatomical variants.
  
  
  RESULTS
  Of the 41 patients, 10 patients (24.4%) showed a complete response (CR) or partial response (PR). Of 41 patients, 22 patients (group A) did not have extrahepatic collateral feeding vessel or an anatomical variant, but 19 patients (group B) did. In group A, 10 patients (45.5%) had a treatment response (CR+PR). However, only one patient (5.3%) had a treatment response (CR+PR) in group B. The response rate in group A was significantly higher than that in group B (45.5 vs. 5.3%; P=0.005). The median survival of group A was significantly longer than that of group B (10.8 vs 3.4 months, P=0.031).
  
  
  CONCLUSIONS
  Hepatic arterial infusion therapy may be useful therapeutic option for patients with advanced HCC, especially in those that do not have extrahepatic collateral feeding vessel or anatomical variant.
authors.affiliation: Department of Internal Medicine, University of Keimyung College of Medicine, Dongsan Medical Center, Daegu, Korea.
authors.forename: Byoung Kuk
authors.initials: BK
authors.lastname: Jang
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Chung
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.forename: Kwang Bum
authors.initials: KB
authors.lastname: Cho
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Kim
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Choi
authors.forename: Jung Hyeok
authors.initials: JH
authors.lastname: Kwon
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000188:drug therapy*; D003097:Collateral Circulation; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged