title: Transarterial chemoembolization as initial treatment for unresectable hepatocellular carcinoma in southern China.
abstract: 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.
authors.affiliation: Department of Hepatobiliary, Cancer Center, Sun Yat-sen University, 651, Dongfeng Road East, Guangzhou 510060, Guangdong Province, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Shi
authors.forename: Ji-An
authors.initials: JA
authors.lastname: Chen
authors.forename: Xiao-Jun
authors.initials: XJ
authors.lastname: Lin
authors.forename: Rong-Ping
authors.initials: RP
authors.lastname: Guo
authors.forename: Yun-Fei
authors.initials: YF
authors.lastname: Yuan
authors.forename: Min-Shan
authors.initials: MS
authors.lastname: Chen
authors.forename: Ya-Qi
authors.initials: YQ
authors.lastname: Zhang
authors.forename: Jin-Qing
authors.initials: JQ
authors.lastname: Li
mesh_terms: 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
chemical_list: D000509:alpha-Fetoproteins