title: Subgrouping of intermediate-stage (BCLC stage B) hepatocellular carcinoma based on tumor number and size and Child-Pugh grade correlated with prognosis after transarterial chemoembolization.
abstract: OBJECTIVE
  To find a subgroup that benefits most from transarterial chemoembolization (TACE) in terms of tumor number and size and liver profile in patients with intermediate-stage hepatocellular carcinoma (HCC).
  
  
  METHODS
  Data of 325 intermediate-stage HCC patients who received TACE as the initial treatment were gathered. Four tumor numbers (3-6 tumors) and five maximum tumor diameters (3-7 cm) as well as all of their combinations but one (3 tumors and 3 cm) and Child-Pugh grade were used as variables to ascertain prognostic factors.
  
  
  RESULTS
  The respective 1-, 3-, and 5-year overall survival rates in all patients were 86.5, 47.0, and 23.7%, respectively. Tumor numbers of 4 (P = 0.00145) and 5 (P = 0.036), and tumor size of 7 cm (P = 0.015), and 12 other combinations of tumor number and size, and Child-Pugh grade (P = 0.0015) were identified as significant prognostic factors in univariate analysis, and 4 tumors of 7 cm (P = 0.0008) and Child-Pugh grade (P = 0.0036) remained significant in the stepwise Cox proportional hazard model. The overall survival was significantly better in a patient subgroup having two factors other than patient subgroups having one or no prognostic factors.
  
  
  CONCLUSIONS
  A patient subgroup having two prognostic factors benefited most from TACE in intermediate-stage HCC patients.
authors.affiliation: Department of Interventional Radiology, School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan, yama@clin.medic.mie-u.ac.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.forename: Shiro
authors.initials: S
authors.lastname: Miyayama
authors.forename: Shozo
authors.initials: S
authors.lastname: Hirota
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Mizunuma
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Inaba
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Maeda
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsuo
authors.forename: Norifumi
authors.initials: N
authors.lastname: Nishida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Aramaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Anai
authors.forename: Shinichi
authors.initials: S
authors.lastname: Koura
authors.forename: Shigeo
authors.initials: S
authors.lastname: Oikawa
authors.forename: Ken
authors.initials: K
authors.lastname: Watanabe
authors.forename: Taku
authors.initials: T
authors.lastname: Yasumoto
authors.forename: Kinya
authors.initials: K
authors.lastname: Furuichi
authors.forename: Masato
authors.initials: M
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden