title: Trans-arterial chemoembolization (TACE) in patients with unresectable Hepatocellular carcinoma: Experience from a tertiary care centre in India.
abstract: OBJECTIVE
  To evaluate the outcome following transarterial chemoembolization (TACE) and to identify the predictors of survival in patients with unresectable hepatocellular carcinoma (HCC).
  
  
  METHODS
  HCC patients reporting to our hospital (2001-2007) were subjected to clinical, biochemical, and radiological examination. TACE was performed in those who fulfilled the inclusion criteria. Follow-up assessment was done with multiphase CT scan of the liver at 1, 3, and 6 months. Tumor response and survival rate were estimated. Univariate and multivariate analyses were done for determinants of survival.
  
  
  RESULTS
  A total of 73 patients (69 males, 4 females; mean age 49±13.4 years) were subjected to 123 sessions of TACE. The Child's classification was: A - 56 patients and B - 17 patients. Barcelona Clinic staging was: A - 20 patients, B - 38 patients, and C - 15 patients. Tumor size was ≤5cm in 28 (38%) patients, >5-10 cm in 28 (38%) patients, and >10 cm in 17 (23%) patients. Median follow-up was for 12 months (range: 1-77 months). No significant postprocedure complications were encountered. Overall survival rate was 66%, 47%, and 36.4% at 1, 2, and 3 years, respectively. Tumor size emerged as an important predictor of survival.
  
  
  CONCLUSIONS
  TACE offers a reasonable palliative therapy for HCC. Initial tumor size is an independent predictor of survival.
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shashi Bala
authors.initials: SB
authors.lastname: Paul
authors.forename: Shivanand
authors.initials: S
authors.lastname: Gamanagatti
authors.forename: Vishnubhatla
authors.initials: V
authors.lastname: Sreenivas
authors.forename: Sheragaru Hanumanhtappa
authors.initials: SH
authors.lastname: Chandrashekhara
authors.forename: Amar
authors.initials: A
authors.lastname: Mukund
authors.forename: Manpreet Singh
authors.initials: MS
authors.lastname: Gulati
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Gupta
authors.forename: Subrat Kumar
authors.initials: SK
authors.lastname: Acharya