title: Chemoembolization of intermediate stage hepatocellular carcinomas: results from a Nordic tertiary liver cancer center.
abstract: BACKGROUND
  Transarterial chemoembolization (TACE) is used as palliative treatment of hepatocellular carcinoma (HCC). Most publications are from HCC patient populations where viral hepatitis is the primary cause of liver disease. In the Nordic countries, most patients have either alcohol-induced cirrhosis or are noncirrhotic. The aim of this single-center study was to evaluate patient characteristics, survival, and side effects of TACE in a Danish referral center for HCC treatment.
  
  
  METHODS
  Fifty-nine consecutive patients with HCC, treated with TACE, either chemoembolization with drug-eluting beads or conventional-TACE with Lipiodol, were included in the study. Their medical records were retrospectively reviewed, computed tomography images analyzed, and biochemical markers recorded. The primary endpoint was overall survival. Analyses were by intention to treat.
  
  
  RESULTS
  Thirty-five patients (59 %) had HCC on a background of liver cirrhosis most often caused by alcohol (60 % of cirrhotics or 35 % overall). Before the first chemoembolization, the patients had a median Child-Pugh score of 6 (5-7) and a median MELD score of 10 (6-21). Median survival after chemoembolization was 18.9 months (13.1-24.7). TACE patients were hospitalized for an average of 3 days (2-30). Prolonged stay was most often due to side effects-eg. pain (31 %), fever (14 %), nausea (10 %), and infection (10 %). Thirty-three patients (56 %) did not have any side effects.
  
  
  CONCLUSIONS
  In this cohort, we observed an acceptable survival following TACE without significant side effects.
authors.affiliation: Department of Surgical Gastroenterology (Dept. L), Aarhus University Hospital, Nørrebrogade 44, Aarhus C, 8000, Aarhus, Denmark, kasperjarlheltandersen@gmail.com.
authors.forename: Kasper J
authors.initials: KJ
authors.lastname: Andersen
authors.forename: Henning
authors.initials: H
authors.lastname: Grønbaek
authors.forename: Gerda Elisabeth
authors.initials: GE
authors.lastname: Villadsen
authors.forename: Anders Riegels
authors.initials: AR
authors.lastname: Knudsen
authors.forename: Peter
authors.initials: P
authors.lastname: Ott
authors.forename: Hendrik
authors.initials: H
authors.lastname: Vildstrup
authors.forename: Dennis Tønner
authors.initials: DT
authors.lastname: Nielsen
authors.forename: Arindam
authors.initials: A
authors.lastname: Bharadwaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors