title: Reasons for Dropout from Transcatheter Arterial Chemoembolization (TACE) when Served as a Down-Staging Therapy for Advanced Hepatocellular Carcinoma.
abstract: OBJECTIVE
  In this study, we try to investigate the possible causes of failed TACE when it is served as a down-staging therapy for advanced hepatocellular carcinoma.
  
  
  METHODS
  Two hundred and seventy eight patients had diagnoses of unresectable hepatocellular carcinoma but had the possibility to accept a resection if they accepted the successful use of TACE as a down-staging therapy. The patients were divided into two groups based on the result of the down-staging therapy: those within the UCSF criteria (group 1, N = 166) and those outside of the criteria (group 2, N = 112).
  
  
  RESULTS
  There was no significant difference between the two groups in their demographic characteristics or their liver function. There were more tumor targets in the failed group (2.5 ± 1.5) than in the successful group (2.1 ± 1.3) (P = 0.013); however, the difference in the total diameter of the targets per patient did not reach statistical significance (P = 0.321), after one to four TACE sessions, the final AFP level was significantly different between the two groups (P = 0.042); there were more patients with a post-treatment AFP level 400 ng/ml in the failed group(28.7% vs. 20.5%, P=0.042). After comparing the number of TACE sessions between two groups, no significant difference was found (P = 0.659). A logistic regression analysis revealed three independent factors that were associated with the failure of TACE when it was used as a down-staging therapy: the tumor target number, post-TACE AFP level and number of TACE sessions (P < 0.05).
  
  
  CONCLUSIONS
  The current results indicate that post-TACE AFP ≥ 400 ng/ml and more tumor targets were the dropout factors influencing the failure of TACE when it was used as a down-staging therapy for advanced HCC patients who previously met the UCSF criteria.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.forename: Jianyong
authors.initials: J
authors.lastname: Lei
authors.forename: Wentao
authors.initials: W
authors.lastname: Wang
authors.forename: Longying
authors.initials: L
authors.lastname: Lin
authors.forename: Jiaxing
authors.initials: J
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Ma
authors.forename: Lunan
authors.initials: L
authors.lastname: Yan
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D010352:Patient Dropouts; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: C097353:AFP protein, human; D000509:alpha-Fetoproteins