title: Long-term outcome of transcatheter subsegmental and segmental arterial chemoemobolization using lipiodol for hepatocellular carcinoma.
abstract: OBJECTIVE
  To clarify the efficacy of transcatheter hepatic sub-subsegmental, subsegmental, and segmental arterial chemoembolization using lipiodol (subseg/seg lip-TACE) for hepatocellular carcinoma (HCC), long-term outcomes of patients who had been treated using subseg/seg lip-TACE alone were retrospectively examined.
  
  
  METHODS
  Subjects comprised 199 patients with HCC (T1/2/≥3=30/108/61; Child-Pugh A/B/C=115/52/32; Japan Integrated Staging [JIS] score≤1/2/≥3=88/64/47) who underwent subseg/seg lip-TACE using lipiodol mixed with an anticancer drug followed by injection of gelatin sponge particles. Each patient was followed-up every 3 months, and repeat subseg/seg lip-TACE and/or conventional lip-TACE was performed in cases showing recurrence. One-, 3-, 5-, 7-, and 10-year cumulative survival rates were calculated. Subgroup analyses were performed by stratifying the population according to T-factor, Child-Pugh classification, and JIS score.
  
  
  RESULTS
  Median duration of follow-up was 3.8 years (range 0.2 to 16.4). Median overall survival was 3.8 years. One-, 3-, 5-, 7- and 10-year survival rates were 91.5, 66.1, 38.8, 20.3, and 9.4% for all patients, and 95.5, 76.9, 51.9, 27.9 and 20.4% for patients with JIS≤1, respectively. Significant survival differences were found across two subgroups of staging systems (T2 vs. T3≤[P=0.0012] and JIS score≤1 vs. 2 [P=0.0036]).
  
  
  CONCLUSIONS
  This study demonstrated that subseg/seg lip-TACE is a feasible treatment for obtaining prolonged survival in patients with localized HCC showing rich vasculature. Outcomes are influenced by both tumor stage and liver function, as seen in the best prolonged survival in patients with JIS score≤1.
authors: Department of Radiology, Nara Medical University, Nara, 634-8522, Japan.
authors: Satoshi
authors: S
authors: Takaki
authors: Hiroshi
authors: H
authors: Sakaguchi
authors: Hiroshi
authors: H
authors: Anai
authors: Toshihiro
authors: T
authors: Tanaka
authors: Kiyosei
authors: K
authors: Yamamoto
authors: Kengo
authors: K
authors: Morimoto
authors: Hideyuki
authors: H
authors: Nishiofuku
authors: Masayoshi
authors: M
authors: Inoue
authors: Satoru
authors: S
authors: Sueyoshi
authors: Takeshi
authors: T
authors: Nagata
authors: Teruyuki
authors: T
authors: Hidaka
authors: Hideo
authors: H
authors: Uchida
authors: Kimihiko
authors: K
authors: Kichikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003952:Diagnostic Imaging; D004998:Ethiodized Oil / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004998:Ethiodized Oil