title: Selective and sequential transarterial chemoembolization: survival in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  To assess the survival time of patients with HCC following transarterial chemoembolization performed in a highly selective and sequential way.
  
  
  METHODS
  124 HCC patients (102 male, 22 female; mean age 63±11 years) treated with selective and sequential chemoembolization at a single center were included. Selective chemoembolization was performed through a coaxially introduced microcatheter in a segmental or subsegmental hepatic artery. Treatment was stopped after complete stasis of the blood flow in the tumor-feeding vessel. The primary endpoint of the study was overall survival.
  
  
  RESULTS
  The median overall survival of the entire patient population was 27.2 months (mo) (±8.9 mo, 95% CI 9.8 mo, 44.6 mo). When stratified according to liver function the median survival was 46.1 mo (±9.0 mo; 95% CI 28.5 mo, 63.7 mo) for Child-Pugh A and 11.1 mo (±4.3 mo; 95% CI 2.7 mo, 19.5 mo) for Child-Pugh B (p<.001). The median survival was 46.1 mo (±16.6 mo; 95% CI 13.5 mo, 78.7 mo) for BCLC stage A, 19.7 mo (±2.6 mo; 95% CI 14.6 mo, 24.8 mo) for BCLC stage B, and 14.4 mo (±5.0 mo; 95% CI 4.5 mo, 24.3 mo) for BCLC stage C (p<.01).
  
  
  CONCLUSIONS
  Selective and sequential chemoembolization offers long survival times in patients with HCC. Those patients with preserved liver function benefit more than patients with limited liver reserve.
authors: Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University at Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. antoch@med.uni-duesseldorf.de
authors: Gerald
authors: G
authors: Antoch
authors: Grit
authors: G
authors: Roelle
authors: Susanne C
authors: SC
authors: Ladd
authors: Hilmar
authors: H
authors: Kuehl
authors: Till A
authors: TA
authors: Heusner
authors: Georgios C
authors: GC
authors: Sotiropoulos
authors: Philip
authors: P
authors: Hilgard
authors: Michael
authors: M
authors: Forsting
authors: Ruediger
authors: R
authors: Verhagen
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000401:mortality*; D004998:Ethiodized Oil / Q000627:therapeutic use*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D015995:Prevalence; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D006490:Hemostatics; D016685:Mitomycin; D004998:Ethiodized Oil