title: The effect of using different embolic agents on survival in transarterial chemoembolization of hepatocellular carcinoma: gelfoam versus polyvinyl alcohol.
abstract: OBJECTIVE
  We aimed to compare the effect of using different embolic agents such as gelfoam and polyvinyl alcohol (PVA) on survival, tumor response, and complications in transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) patients.
  
  
  METHODS
  We retrospectively reviewed the medical records of 38 inoperable HCC patients who underwent TACE between August 1998 and April 2007. A total of 50 TACE sessions were performed using PVA (n=18) or gelfoam particles (n=20), following the application of 60 mg doxorubicin with 10-20 mL lipiodol emulsion. The PVA and gelfoam groups were compared based on clinical, laboratory and demographic variables. Survival rates were calculated starting from the first TACE session using the Kaplan-Meier analysis.
  
  
  RESULTS
  There was no significant difference between the survival rates of PVA and gelfoam groups (P = 0.235). Overall survival rates at 12, 24, 36, 48, and 60 months were 55%, 36%, 15%, 7%, and 5%, respectively. Tumor response, age, lipiodol accumulation type, number of HCC foci, complications and serum alpha-fetoprotein level were significant factors for survival in all patients.
  
  
  CONCLUSIONS
  Use of gelfoam or PVA as the embolic agent did not have a significant impact on survival. Complete tumor response, intensive lipiodol accumulation in tumor, older age (<60 years), fewer (≤3) HCC foci, low serum alpha-fetoprotein level (≤400 ng/mL) were found to improve cumulative survival significantly.
authors.affiliation: Department of Radiology, Pamukkale University School of Medicine, Denizli, Turkey. alkoc@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Koçyiğit
authors.forename: Oğuz
authors.initials: O
authors.lastname: Dicle
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Göktay
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Astarcıoğlu
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000008:administration & dosage*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D011142:Polyvinyl Alcohol