Transarterial chemoembolization as initial treatment for unresectable hepatocellular carcinoma in southern China.
OBJECTIVE
To identify prognostic factors from pretreatment variables of the initial transarterial chemoembolization (TACE) procedure in unresectable hepatocellular carcinoma (HCC).


METHODS
One thousand and five hundred and sixty-nine patients with unresectable HCC underwent TACE as initial treatment were retrospectively studied. Pretreatment variables of the initial TACE procedure with a P value less than 0.05 by univariate analysis were subjected to Cox proportional hazards model.


RESULTS
The median overall survival time and 1-, 5-, 10-year survival rates were 10.37 mo, 47%, 10%, and 7%, respectively. A Cox proportional hazard model showed that 8 pretreatment factors of regional lymph nodes metastasis, Child-Pugh class, macrovascular invasion, greatest dimension, alpha-fetoprotein (AFP), Hepatitis virus B, tumor capsule, and nodules were independent prognostic factors. Patients with multimodality therapy have better survival than those with TACE treatment only.


CONCLUSIONS
Tumor status, hepatic function reserve, AFP, and hepatitis virus B status were independent prognostic factors for unresectable HCC. Distant metastasis might not be a contraindication to TACE. Multimodality therapy might improve survival.
Shi
Ming
M
Department of Hepatobiliary, Cancer Center, Sun Yat-sen University, 651, Dongfeng Road East, Guangzhou 510060, Guangdong Province, China.
Chen
Ji-An
JA
Lin
Xiao-Jun
XJ
Guo
Rong-Ping
RP
Yuan
Yun-Fei
YF
Chen
Min-Shan
MS
Zhang
Ya-Qi
YQ
Li
Jin-Qing
JQ
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D002681:China / Q000453:epidemiology; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism
D000509:alpha-Fetoproteins