title: Trans-arterial chemo-embolization (TACE), with either lipiodol (traditional TACE) or drug-eluting microspheres (precision TACE, pTACE) in the treatment of hepatocellular carcinoma: efficacy and safety results from a large mono-institutional analysis.
abstract: More data about TACE and pTACE seem necessary to better define the global treatment strategy for HCC. Aim of our analysis was to evaluate the role of TACE, either with lipiodol (traditional) or drug-eluting microspheres in terms of response rate (RR), time to progression (TTP), overall survival (OS) and toxicity in HCC.Patients with HCC undergoing traditional TACE or pTACE (either alone or in combination with other treatment options) were eligibleOne hundred and fifty patients were analyzed. In the global patient population median OS was 46 months for lipiodol TACE and 19 months for pTACE (p < 0.0001), TTP was 30 months versus 16 months for patients receiving TACE or pTACE respectively (p = 0.003). These results were confirmed also among the group of patients who received exclusive TACE or pTACE. Neither RR nor toxicity was different between TACE or pTACE.At multivariate analysis, age, the Okuda stage, type of TACE and number of TACE proved to be independent prognostic factors influencing overall survival.In our experience, lipiodol TACE showed a better OS and TTP over pTACE, without difference in toxicity profile and RR. Among the staging systems analyzed only the Okuda stage seemed able to reliably predict patients outcome.
authors.affiliation: Clinica di Oncologia Medica, AO Ospedali Riuniti-Università Politecnica delle Marche, via Conca, 60020, Ancona, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Scartozzi
authors.forename: Gianluca Svegliati
authors.initials: GS
authors.lastname: Baroni
authors.forename: Luca
authors.initials: L
authors.lastname: Faloppi
authors.forename: Marzia Di Pietro
authors.initials: MD
authors.lastname: Paolo
authors.forename: Chiara
authors.initials: C
authors.lastname: Pierantoni
authors.forename: Roberto
authors.initials: R
authors.lastname: Candelari
authors.forename: Rossana
authors.initials: R
authors.lastname: Berardi
authors.forename: Stefania
authors.initials: S
authors.lastname: Antognoli
authors.forename: Cinzia
authors.initials: C
authors.lastname: Mincarelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
authors.forename: Cristina
authors.initials: C
authors.lastname: Marmorale
authors.forename: Ettore
authors.initials: E
authors.lastname: Antico
authors.forename: Antonio
authors.initials: A
authors.lastname: Benedetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D004998:Ethiodized Oil / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008863:Microspheres; D009367:Neoplasm Staging; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D004998:Ethiodized Oil