title: Validation of the criteria of transcatheter arterial chemoembolization failure or refractoriness in patients with advanced hepatocellular carcinoma proposed by the LCSGJ.
abstract: BACKGROUND
  Transcatheter arterial chemoembolization (TACE) failure or refractoriness is an indication for sorafenib therapy in patients with advanced hepatocellular carcinoma. The study evaluated the validity of the definition of TACE failure or refractoriness as proposed by the Liver Cancer Study Group of Japan (LCSGJ) through a retrospective analysis of sorafenib treatment.
  
  
  METHODS
  Out of 265 patients with advanced hepatocellular carcinoma who were treated with sorafenib at our hospital, 45 experienced TACE failure or refractoriness and were included in this study and retrospectively analyzed.
  
  
  RESULTS
  Multivariate analysis only identified the number of ineffective TACE procedures performed before starting sorafenib treatment as significant factors. Overall survival (OS) after starting sorafenib was statistically longer in patients treated with ≤2 consecutive ineffective TACE procedures before sorafenib administration than in patients treated with ≥3 consecutive ineffective TACE procedures (p < 0.005). This result matched the LCSGJ criteria.
  
  
  CONCLUSIONS
  In patients treated with sorafenib, OS was extended with ≤2 consecutive ineffective TACE procedures compared to that with ≥3 consecutive ineffective TACE procedures. Thus, if tumors are uncontrolled, TACE should not be repeated. The result of this study supports the definition of TACE failure or refractoriness proposed by the LCSGJ.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan.
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Arizumi
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Ueshima
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chishina
authors.forename: Masashi
authors.initials: M
authors.lastname: Kono
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kitai
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Inoue
authors.forename: Norihisa
authors.initials: N
authors.lastname: Yada
authors.forename: Satoru
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Sakurai
authors.forename: Naoshi
authors.initials: N
authors.lastname: Nishida
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy / Q000821:virology; D016461:Chemoembolization, Therapeutic / Q000379:methods; D005260:Female; D006499:Hepatic Artery; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D000077157:Sorafenib; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib