Comparison of characteristics and transarterial chemoembolization outcomes in patients with unresectable hepatocellular carcinoma and different viral etiologies.
OBJECTIVE
To determine any differences in patient characteristics and outcomes after transarterial chemoembolization between different viral etiologies of hepatocellular carcinoma (HCC).


METHODS
This retrospective study consisted of 201 patients undergoing first-time transarterial chemoembolization for unresectable HCC from January to December 2009. The patients were divided into four groups: hepatitis B virus (HBV) only (n = 104), hepatitis C virus (HCV) only (n = 63), HBV and HCV (n = 10), and no viral hepatitis (n = 24). The clinical and laboratory data were obtained from electronic medical records, and imaging findings obtained before transarterial chemoembolization were analyzed. Kaplan-Meier analyses were used to assess the impact of HBV or HCV status, clinical characteristics, and imaging results on overall survival.


RESULTS
After a median follow-up of 28.3 months ± 16.2, the 1-, 2-, and 3-year overall survival rates were 74.1%, 59.7%, and 53.2%. Patients with HBV had a significant association with younger age (P = .001), higher male-to-female ratio (P = .003), lower alanine aminotransferase levels (P = .018), higher albumin levels (P = .009), and multifocal tumors at diagnosis (P = .04) compared with patients with HCV. Patients with both HBV and HCV had significantly higher serum bilirubin levels compared with the other groups (P = .002). No significant difference was found in overall survival among the different hepatitis groups (P = .943). Multivariate analysis showed that statistically significant determinants for overall survival were Child-Pugh class (P = .002), Barcelona Clinic Liver Cancer stage (P < .001), tumor size (P < .001), and distribution (P < .001).


CONCLUSIONS
Viral etiology has no correlation with the outcome of patients with HCC undergoing transarterial chemoembolization.
Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100.
Bang-Bin
BB
Chen
Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100.
I-Lun
IL
Shih
Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100.
Chih-Horng
CH
Wu
Department of Oncology, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100.
Chiun
C
Hsu
Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100.
Chien-Hung
CH
Chen
Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100.
Tiffany Ting-Fang
TT
Shih
Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100.
Kao-Lang
KL
Liu
Department of Medical Imaging and Radiology, National Taiwan University College of Medicine and Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan 100. Electronic address: e510012@yahoo.com.tw.
Po-Chin
PC
Liang
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage; D006498:Hepatectomy / Q000706:statistics & numerical data; D006525:Hepatitis, Viral, Human / Q000401:mortality* / Q000628:therapy; D006801:Humans; D007269:Injections, Intra-Arterial / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D017211:Treatment Failure; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D006490:Hemostatics