title: Best radiological response to trans-arterial chemoembolization for hepatocellular carcinoma does not imply better outcomes.
abstract: BACKGROUND
  Regional therapy with trans-arterial chemoembolization (TACE) is a common treatment for unresectable hepatocellular carcinoma (HCC). Outcomes were examined in patients with the best radiological response (BR) after the initial TACE.
  
  
  METHODS
  This was a retrospective cohort study of patients who underwent TACE as the initial treatment for HCC between the years 2000 and 2010. BR was defined as complete disappearance of the tumour or no enhancement with contrast on the first cross-sectional imaging study after the initial TACE.
  
  
  RESULTS
  Seventy-eight out of 104 total consecutive patients were identified with the potential for a BR to TACE therapy for unresectable HCC, and 24 met the criteria for BR. Patients with BR had a median survival of 12.8 months (2.2-54.9) compared with 18.9 months(1.3-56.7) for the entire cohort (P= 0.313). The median time to progression was 10.6 months (1.2-24.3) in the BR group and 3.2 months (0.7-49.2) in the patients without a BR (P= 0.003).
  
  
  CONCLUSIONS
  BR to initial TACE for unresectable HCC is associated with comparable survival to those without BR in spite of a longer time to cancer progression. It may be reasonable to consider further therapy such as repeat TACE or biological/systemic therapy in patients with HCC even when the radiological response to the initial TACE is favourable.
authors: Departments of Surgery Radiology Medicine, The Ohio State University College of Medicine, Columbus, OH43210-1240, USA.
authors: Jon C
authors: JC
authors: Henry
authors: Lavina
authors: L
authors: Malhotra
authors: Hooman
authors: H
authors: Khabiri
authors: Gregory
authors: G
authors: Guy
authors: Anthony
authors: A
authors: Michaels
authors: James
authors: J
authors: Hanje
authors: Marcela
authors: M
authors: Azevedo
authors: Mark
authors: M
authors: Bloomston
authors: Carl R
authors: CR
authors: Schmidt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
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