title: Multivariate analysis of prognostic factors for survival following doxorubicin-eluting bead transarterial chemoembolization for hepatocellular carcinoma.
abstract: OBJECTIVE
  To identify prognostic factors for survival in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization with doxorubicin-eluting beads (DEBs).
  
  
  METHODS
  In a retrospective, single-center analysis, tumor- and patient-related factors were recorded for univariate and multivariate analyses via Kaplan-Meier and Cox regression. Infiltrative HCC phenotype and portal vein invasion (PVI) were correlated, and patients with either or both were classified as having radiographically advanced (RAdv) HCC. The primary endpoint was overall survival, which was calculated from the time of first DEB chemoembolization procedure.
  
  
  RESULTS
  A total of 168 patients underwent 248 procedures, of which 215 (86.7%) were outpatient procedures. Mean length of stay was 0.33 days, and 25 patients (10.1%) were readmitted within 30 days. A total of 33 patients underwent liver transplantation and were excluded from survival analyses. A total of 130 had cirrhosis; 62, 50, and 18 had Child class A, B, and C disease, respectively. Forty-one patients had infiltrative HCC phenotype, 28 of whom also had PVI. Multivariate analysis of survival in all patients showed α-fetoprotein (AFP), performance status (PS), RAdv HCC, Child classification, albumin level, and ascites to predict survival. In patients without RAdv HCC, AFP, PS, Child classification, albumin level, and International Normalized Ratio were independent predictors. Increased bilirubin level was not an independent risk factor for death.
  
  
  CONCLUSIONS
  Independent prognostic factors in patients with HCC undergoing DEB chemoembolization have been identified. Increased bilirubin level was not an independent risk factor. These data can be used in HCC patient selection and counseling for DEB chemoembolization.
authors: Hepatobiliary Service, Piedmont Transplant Institute, Piedmont Hospital, Atlanta, GA 30309, USA. marty.sellers@piedmont.org
authors: Marty T
authors: MT
authors: Sellers
authors: Sidney
authors: S
authors: Huggins
authors: Kristy
authors: K
authors: Kegley
authors: Harrison S
authors: HS
authors: Pollinger
authors: Roshan
authors: R
authors: Shrestha
authors: Mark W
authors: MW
authors: Johnson
authors: Lance L
authors: LL
authors: Stein
authors: Chakri
authors: C
authors: Panjala
authors: Miguel
authors: M
authors: Tan
authors: Aravind
authors: A
authors: Arepally
authors: Louis
authors: L
authors: Jacobs
authors: Christopher
authors: C
authors: Caldwell
authors: Michael
authors: M
authors: Bosley
authors: Steven J
authors: SJ
authors: Citron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000401:mortality*; D004317:Doxorubicin / Q000008:administration & dosage*; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D004317:Doxorubicin
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