title: Early evaluation of transcatheter arterial chemoembolization-refractory hepatocellular carcinoma.
abstract: BACKGROUND
  There is no standard therapy for patients with transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC). This study examined whether evaluating the tumor effect (TE) at 1 week after TACE was useful for predicting refractoriness to TACE.
  
  
  METHODS
  We performed a historical cohort study involving 54 patients and 119 tumors. TE was evaluated at 1 week and 3 months after TACE, and an overall evaluation was also performed at 3 months based on the response evaluation criteria in cancer of the liver.
  
  
  RESULTS
  Among 45 tumors evaluated as TE2 at 1 week, 43 tumors (95.6%) were classified as TE1 or TE2 at 3 months. Of the 24 patients whose tumors were categorized as TE2 at 1 week, none achieved a complete or partial response.
  
  
  CONCLUSIONS
  Evaluating the TE at 1 week after TACE is useful for the early diagnosis of TACE-refractory HCC and allows alternative treatment options, such as sorafenib, to be employed before the disease progresses.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Kenya
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Etsuro
authors.initials: E
authors.lastname: Hatano
authors.forename: Koji
authors.initials: K
authors.lastname: Kitamura
authors.forename: Taku
authors.initials: T
authors.lastname: Iida
authors.forename: Takamichi
authors.initials: T
authors.lastname: Ishii
authors.forename: Takahumi
authors.initials: T
authors.lastname: Machimito
authors.forename: Kojiro
authors.initials: K
authors.lastname: Taura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yasuchika
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Isoda
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shibata
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use; D000077157:Sorafenib; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib