title: Risk factors for recurrence after transarterial chemoembolization for early-stage hepatocellular carcinoma.
abstract: BACKGROUND
  Radiofrequency ablation (RFA) is a standard therapy for the treatment of hepatocellular carcinoma (HCC) with 3 or fewer tumors of up to 3 cm (early-stage HCC); when RFA is unsuccessful or unfeasible, transcatheter arterial chemoembolization (TACE) has often been performed. However, little information about the outcome of TACE for early-stage HCC has been reported and it is hard to decide whether to perform additional treatment following TACE in these difficult conditions. The aim of this study was to determine the risk factors for local or intrahepatic distant recurrence after TACE in early-stage HCC.
  
  
  METHODS
  Among 1,560 newly diagnosed HCC patients who were admitted to Okayama University Hospital, 43 patients with early-stage HCC who received only TACE in at least one nodule were enrolled in this study. We analyzed the risk factors for local and distant recurrence by the Cox proportional hazard model.
  
  
  RESULTS
  The local recurrence rates and intrahepatic distant recurrence rates at 3 months, 6 months, and 1 year were 18.6, 33.4, and 61.8%, and 2.8, 2.8, and 34.3%, [corrected] respectively.Among 12 parameters examined as possible risk factors for recurrence, heterogeneous Lipiodol uptake (risk ratio 3.38; 95% confidence interval 1.14-10.60) and high serum des-gamma-carboxy prothrombin (DCP) (2.58; 1.03-7.14) were significantly correlated with local recurrence, and the presence of multiple tumors (10.64; 1.76-93.75) was significantly correlated with intrahepatic distant recurrence.
  
  
  CONCLUSIONS
  Heterogeneous Lipiodol uptake, high serum DCP, and multiple tumors are risk factors for recurrence in patients with early-stage HCC who have undergone palliative TACE.
authors: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. gyacy14@gmail.com
authors: Hideaki
authors: H
authors: Kinugasa
authors: Kazuhiro
authors: K
authors: Nouso
authors: Yasuto
authors: Y
authors: Takeuchi
authors: Tetsuya
authors: T
authors: Yasunaka
authors: Hideki
authors: H
authors: Onishi
authors: Shin-ichiro
authors: S
authors: Nakamura
authors: Hidenori
authors: H
authors: Shiraha
authors: Kenji
authors: K
authors: Kuwaki
authors: Hiroaki
authors: H
authors: Hagihara
authors: Fusao
authors: F
authors: Ikeda
authors: Yasuhiro
authors: Y
authors: Miyake
authors: Akinobu
authors: A
authors: Takaki
authors: Kazuhide
authors: K
authors: Yamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D004998:Ethiodized Oil / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; C008208:acarboxyprothrombin; D004998:Ethiodized Oil; D011516:Prothrombin