title: Selective balloon-occluded transarterial chemoembolization for patients with one or two hepatocellular carcinoma nodules: Retrospective comparison with conventional super-selective TACE.
abstract: OBJECTIVE
  Selective balloon-occluded transarterial chemoembolization (B-TACE) enables strong TACE; infusion of more volume of lipiodol emulsion and forceful injection of embolization materials. The aim of this study is to analyze the efficacy of B-TACE for patients with one or two hepatocellular carcinoma (HCC) nodules compared with conventional super-selective TACE using a microcatheter (C-TACE).
  
  
  METHODS
  We retrospectively selected patients without previous history of TACE, with one or two HCC nodules, with performance status 0/1, and with liver function of Child-Pugh score A/B. Between 2008 and 2010, a 3-Fr microballoon catheter was used for targeted TACE (B-TACE group). Between 2005 and 2008, a 2-Fr microcatheter was used (C-TACE group). Control rates of primary nodule, overall survival rates and tumor-free rates in the liver were calculated for each group using the Kaplan-Meier method. Univariate analysis was performed to compare between the groups using the log-rank test. Multivariate analysis was performed for analysis of prognostic factors using Cox's proportional hazard model. The factors were B-TACE versus C-TACE, Child-Pugh score A versus B, single nodule versus double, large nodule versus small , elder versus not, and prior radiofrequency ablation treatment versus not.
  
  
  RESULTS
  Control rates of the primary nodule were improved by B-TACE. B-TACE was an independent factor to improve both control rates of the primary nodule and overall survival rates. Child-Pugh score A was an independent factor to increase overall survival rates. There was no statistically significant difference in overall survival or tumor-free survival rates between the groups.
  
  
  CONCLUSIONS
  B-TACE was an independent factor to improve overall survival rates on multivariate analysis, but there was no significant difference in overall survival rates between B-TACE and C-TACE groups on univariate analysis.
authors.affiliation: Department of Radiology, Hitachi General Hospital.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Irie
authors.affiliation: Department of Radiology, Hitachi General Hospital.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kuramochi
authors.affiliation: Department of Radiology, Tsukuba Memorial Hospital.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kamoshida
authors.affiliation: Department of Hepato-Gastroenterology, Hitachi General Hospital.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takahashi
keywords: balloon-occluded transarterial chemoembolization; hepatocellular carcinoma; transarterial chemoembolization