title: Benefits and problems of transarterial therapy in patients with hepatocellular carcinoma and chronic kidney disease.
abstract: OBJECTIVE
  To evaluate the feasibility of transarterial therapy (transcatheter arterial chemoembolization and transcatheter arterial infusion) for patients with hepatocellular carcinoma and chronic kidney disease (CKD).
  
  
  METHODS
  The study enrolled 35 patients who received transarterial therapy. The patients were classified into a CKD group (n = 10 nondialysis chronic kidney disease [NDCKD] and n = 9 end-stage renal disease [ESRD]) or a non-CKD group (n = 16). The survival rates between the two groups were compared using two different starting points: (a) from initial diagnosis of hepatocellular carcinoma and (b) from enrollment in the study. The tolerance of transarterial therapy in patients with CKD was evaluated by comparing the incidence of major adverse events.
  
  
  RESULTS
  The 2-year and 5-year survival rates from initial diagnosis were 83.9% and 53.8% in the CKD group and 70.1% and 40.4% in the non-CKD group (P = .478). The corresponding 3-year survival rate from enrollment in the two groups was 25.6% and 41.2%, respectively (P = .995). The 2-year and 5-year survival rates from initial diagnosis were 70.1% and 40.4% in the non-CKD group, 90.0% and 39.4% in NDCKD patients, and 76.2% and 76.2% in ESRD patients (P = .380). The corresponding 2-year survival rates from enrollment in these groups were 54.9%, 48.0%, and 48.6% (P = .943). Severe contrast-induced nephropathy (n = 3) and late-onset death caused by cholesterol crystal embolism (n = 1) were observed in the NDCKD group.
  
  
  CONCLUSIONS
  Transcatheter arterial chemoembolization is feasible in patients with CKD by instituting periprocedural hemodialysis with similar 2-year and 5-year survival compared with patients without CKD.
authors.affiliation: Department of Gastroenterology, Kitasato University Medical Center, 6-100 Arai, Kitamoto, Saitama, 364-8501, Japan. Electronic address: masaaki@kitasato-u.ac.jp.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Risk Management and Health Care Administration, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Akitaka
authors.initials: A
authors.lastname: Shibuya
authors.affiliation: Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Minamino
authors.affiliation: Department of Nephrology in Internal Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Murano
authors.affiliation: Diagnostic Radiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsunaga
authors.affiliation: Diagnostic Radiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Diagnostic Radiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Gou
authors.initials: G
authors.lastname: Ogasawara
authors.affiliation: Diagnostic Radiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Tsugumi
authors.initials: T
authors.lastname: Irie
authors.affiliation: Diagnostic Radiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Woodhams
authors.affiliation: Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000188:drug therapy / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D015251:Epirubicin / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D015251:Epirubicin; C406530:miriplatin; D004998:Ethiodized Oil; D002945:Cisplatin