title: Risk factors for death in 224 cases of hepatocellular carcinoma after transcatheter arterial chemoembolization.
abstract: OBJECTIVE
  Transcatheter arterial chemoembolization (TACE) has been reported as effective therapy for unresectable hepatocellular carcinoma (HCC), however, few have described methods for predicting prognosis, especially in patients treated by repeated TACE. To determine risk factors for death and try to predict the prognosis, we evaluated clinical data.
  
  
  METHODS
  We retrospectively analyzed the clinical parameters of 224 patients with unresectable HCC treated with repeated TACE from January 1997 to December 2007. TACE was repeated when recurrence was diagnosed by tumor marker elevation and/or dynamic computed tomography findings. Factors affecting survival were evaluated using multivariate analysis after univariate analysis. Next, we combined the score for each significant factor into a single prognostic score and added up the positive factors in each case, then analyzed the significance of prognosis, after which the results were compared with other prognostic scoring systems.
  
  
  RESULTS
  Multivariate analysis revealed that bilobular HCC, alpha-fetoprotein (> or = 400 ng/ml), tumor invasion of the portal vein, tumor size (> or = 10 cm), and albumin (< 2.8 g/dl) were related to poor prognosis, and developed a prognostic scoring system from those. According to that score, patients were classified into 5 groups.
  
  
  CONCLUSIONS
  Our scoring system was easily performed and the results showed that repeated TACE should not be administered to patients with scores of 3 or more.
authors.affiliation: Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, Japan. hirage@m.ehime-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiraoka
authors.forename: Norio
authors.initials: N
authors.lastname: Horiike
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yohei
authors.initials: Y
authors.lastname: Koizumi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Doi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ichikawa
authors.forename: Aki
authors.initials: A
authors.lastname: Hasebe
authors.forename: Makoto
authors.initials: M
authors.lastname: Yano
authors.forename: Yasunao
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ootani
authors.forename: Kazuto
authors.initials: K
authors.lastname: Takamura
authors.forename: Hideki
authors.initials: H
authors.lastname: Kawasaki
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Otomi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kogame
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sogabe
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ishimaru
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kashihara
authors.forename: Masao
authors.initials: M
authors.lastname: Miyagawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D000368:Aged; D000418:Albumins / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D009361:Neoplasm Invasiveness; D011169:Portal Vein / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000418:Albumins; D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins