title: Improved time to progression for transarterial chemoembolization compared with transarterial embolization for patients with unresectable hepatocellular carcinoma.
abstract: BACKGROUND
  Embolizing branches of the hepatic artery lengthens survival for patients with unresectable hepatocellular carcinoma (HCC), but the benefit of combining chemotherapy with the embolizing particles remains controversial.
  
  
  METHODS
  A retrospective review was undertaken of sequential patients with advanced HCC undergoing embolization in the past 10 years at 2 neighboring institutions and with 2 years of follow-up data. TACE was generally performed with doxorubicin plus mitomycin C.
  
  
  RESULTS
  One hundred twenty-four patients were included; 77 received TACE and 47 received TAE. On multivariable analysis stratified by institution, type of embolization and CLIP score significantly predicted PFS and time to progression (TTP), whereas CLIP score and AFP independently predicted overall survival (OS). TACE significantly prolonged PFS and TTP (P = .0004 and P = .001, respectively), but not OS (P = .83).
  
  
  CONCLUSIONS
  The addition of chemotherapy to TAE prolongs PFS and TTP. Future efforts should focus on adjunctive therapies after the embolization to increase survival.
authors.affiliation: Duke University Medical Center, Durham, NC, USA. morse004@mc.duke.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Morse
authors.forename: Brent A
authors.initials: BA
authors.lastname: Hanks
authors.forename: Paul
authors.initials: P
authors.lastname: Suhocki
authors.forename: Phuong L
authors.initials: PL
authors.lastname: Doan
authors.forename: Emily A
authors.initials: EA
authors.lastname: Liu
authors.forename: Patricia
authors.initials: P
authors.lastname: Frost
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Bernard
authors.forename: Andrea
authors.initials: A
authors.lastname: Tsai
authors.forename: Dominic T
authors.initials: DT
authors.lastname: Moore
authors.forename: Bert H
authors.initials: BH
authors.lastname: O'Neil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D018450:Disease Progression; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D016685:Mitomycin; D004317:Doxorubicin